title: Analgesic control and functional outcome after knee arthroscopy: results of a randomized double-blinded trial comparing a hyaluronic acid supplement with bupivacaine.
abstract: OBJECTIVE
  Hyaluronic acid (HA) is a naturally occurring substance within normal synovial joints. Although its efficacy in treating osteoarthritis has been evaluated, it has not been established whether it is of benefit after routine arthroscopic procedures. We hypothesized that immediate supplementation with HA after completion of arthroscopy would result in improved short-term analgesic and functional outcomes after knee arthroscopy.
  
  
  METHODS
  Double-blinded randomized controlled trial.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  One hundred ten patients presenting for routine arthroscopic procedures were invited to participate in the study. After exclusion criteria were applied, 98 patients were randomized to receive either 10 mL of 0.5% bupivacaine or 3 mL of HA into the joint immediately after completion of surgery.
  
  
  METHODS
  After completion of surgery, all patients were randomized to receive either 10 mL of 0.5% bupivacaine or 3 mL of HA into the knee joint.
  
  
  METHODS
  Visual analogue scale (VAS) pain scores were obtained at baseline; 1, 2, and 24 hours; and 1, 2, and 6 weeks after surgery. Western Ontario and McMaster Universities (WOMAC) and Tegner-Lysholm scores were obtained at baseline and then at 1, 2, and 6 weeks after surgery.
  
  
  RESULTS
  Forty-nine patients received intra-articular bupivacaine and 49 received HA. There was no statistical difference in any of the outcome measures (VAS pain scores, WOMAC, and Tegner-Lysholm) at any time point between the groups overall.
  
  
  CONCLUSIONS
  There was no benefit of HA injection immediately at the end of knee arthroscopy in the first 6 weeks after surgery.
  
  
  CONCLUSIONS
  Routine use of HA at the time of knee arthroscopy cannot be recommended.
authors.affiliation: Sports Surgery Clinic, Dublin, Ireland. joseph.f.baker@gmail.com
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Baker
authors.forename: Gandhi N
authors.initials: GN
authors.lastname: Solayar
authors.forename: Damien P
authors.initials: DP
authors.lastname: Byrne
authors.forename: Ray
authors.initials: R
authors.lastname: Moran
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Mulhall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001182:Arthroscopy; D002045:Bupivacaine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D012044:Regression Analysis; D016896:Treatment Outcome; D055675:Viscosupplements / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D055675:Viscosupplements; D006820:Hyaluronic Acid; D002045:Bupivacaine