Intra-articular sodium hyaluronate injections in the osteoarthritic ankle joint: effects, safety and dose dependency.
BACKGROUND
To determine the efficacy, safety and dose dependency of intra-articular Orthovisc(®) hyaluronic acid injections in the ankle.


METHODS
A prospective single blinded study in patients with symptomatic ankle-osteoarthritis. Patients were randomly allocated to 1, 2, 3 ml, or 3 weekly injections of 1 ml (3 × 1 ml). Primary outcome was 'pain during walking' at 15 weeks measured on a 100mm VAS.


RESULTS
Twenty-six patients (ITT) participated. The 3 × 1 ml dose group showed statistically significant decreases at week 7 for 'pain during walking' and 'pain at rest' (p=0.046). At week 15 decreases were significant for 'pain at rest' (p=0.046). There was no significant decrease of VAS-scores in any of the single dose groups. Seven patients experienced temporary local swelling and increased pain in the injected ankle.


CONCLUSIONS
Orthovisc(®) viscosupplementation in the ankle joint is effective and well tolerated. The 3 × 1 ml dose regimen shows the best results.
Afdeling Orthopedie, St. Maartenskliniek, Hengstdal 3, P.O. Box 9011, 6500 GM Nijmegen, The Netherlands. a.witteveen@maartenskliniek.nl
Angelique G H
AG
Witteveen
Inger N
IN
Sierevelt
Leendert
L
Blankevoort
Gino M M J
GM
Kerkhoffs
C Niek
CN
van Dijk
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007270:Injections, Intra-Articular; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D011446:Prospective Studies; D016037:Single-Blind Method; D055675:Viscosupplements / Q000008:administration & dosage*; D016138:Walking / Q000502:physiology; D055815:Young Adult
D055675:Viscosupplements; C477349:orthovisc; D006820:Hyaluronic Acid