title: Clinical and MRI outcomes of HA injection following arthroscopic microfracture for osteochondral lesions of the talus.
abstract: OBJECTIVE
  The purpose of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture surgery alone or in combination with hyaluronic acid (HA) injection in the treatment of osteochondral lesions of the talus.
  
  
  METHODS
  Thirty-five patients with osteochondral lesions of the talus who underwent arthroscopic microfracture were included and followed up for at least 9 months post-operatively. The patients were randomly divided into non-injection group (n = 17) who received treatment with microfracture surgery alone and injection group (n = 18) who also accepted intra-articular injection of HA post-operatively. Quantitative MRI was used to evaluate the cartilage repair after surgery. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind foot Scale scores and Visual Analogue Scale (VAS) scores were used to evaluate clinical outcomes.
  
  
  RESULTS
  After operation, the MRI outcomes showed that the thickness index was higher (0.8 ± 0.1 vs. 0.7 ± 0.1) and the T2 index was lower (1.2 ± 0.1 vs. 1.4 ± 0.1) in the injection group than in the non-injection group (P < 0.01). As for the volumes of subchondral bone marrow oedema, there are no significant differences between groups (n.s.). Compared with the non-injection group, the AOFAS score and the VAS score yielded a higher level of improvement in injection group at final follow-up post-operatively (P < 0.05).
  
  
  CONCLUSIONS
  Arthroscopic microfracture is a safe and effective procedure for osteochondral lesions of the talus. Intra-articular HA injection as an adjunct to arthroscopic microfracture might offer better functional recovery than microfracture alone.
  
  
  METHODS
  II.
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Xi-Liang
authors.initials: XL
authors.lastname: Shang
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Hong-Yue
authors.initials: HY
authors.lastname: Tao
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China. Chensy136@163.com.
authors.forename: Shi-Yi
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Yun-Xia
authors.initials: YX
authors.lastname: Li
authors.affiliation: Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China. hua023@hotmail.com.
authors.forename: Ying-Hui
authors.initials: YH
authors.lastname: Hua
mesh_terms: D000328:Adult; D054544:Arthroplasty, Subchondral; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging; D008297:Male; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D055675:Viscosupplements / Q000627:therapeutic use*; D064232:Visual Analog Scale
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Hyaluronic acid; Microfracture; Osteochondral lesions of talus; Quantitative MRI