title: Effects of repetitive injections of hyaluronic acid on peritendinous adhesions after flexor tendon repair: a preliminary randomized, placebo-controlled clinical trial.
abstract: BACKGROUND
  The aim of this study was to investigate the efficacy of three injections of hyaluronic acid (HA) versus placebo (saline) over a two-week period on functional outcomes after zone-II flexor tendon repairs.
  
  
  METHODS
  Twenty-two patients with isolated zone-II flexor tendon injury of the index fingers were included in this study. Before tenorrhaphy, fingers were randomly divided into two groups; 11 were treated with three injections of HA around the tenorrhaphy site and 11 served as a placebo group and were treated with saline in the same way. The first dose was given at the time of tenorrhaphy and two additional doses were given at one-week intervals. A Kleinert rehabilitation protocol was employed postoperatively. Range of motion was assessed with total active and passive movement evaluation systems at 3 weeks, 3 months and long-term. Functional outcome was evaluated using the Strickland classification.
  
  
  RESULTS
  There were no differences between the two groups in terms of range of motion at 3 weeks. However, at 3 months and long-term, a significant improvement was observed in fingers treated with HA compared to placebo.
  
  
  CONCLUSIONS
  This preliminary placebo-controlled study suggests that repetitive injections of HA can improve clinical outcomes presumably due to the effect on decreasing adhesions in primary tendon repairs.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Uludağ University Faculty of Medicine, Bursa, Turkey. gozgenel@yahoo.com
authors.forename: Güzin Yeşim
authors.initials: GY
authors.lastname: Ozgenel
authors.forename: Abdullah
authors.initials: A
authors.lastname: Etöz
mesh_terms: D000328:Adult; D001182:Arthroscopy; D004311:Double-Blind Method; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections; D008297:Male; D016059:Range of Motion, Articular; D013708:Tendon Injuries / Q000601:surgery*; D000267:Tissue Adhesions / Q000517:prevention & control; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid