Hyaluronic Acid Similar to Placebo for Ankle Arthritis

Single injection of hyaluronic acid to treat ankle osteoarthritis is not superior to saline solution

MONDAY, Jan. 16 (HealthDay News) -- A single intra-articular injection of hyaluronic acid was no more effective in treating osteoarthritis of the ankle than an injection of normal saline solution, according to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery.

Henry DeGroot III, M.D., of Newton-Wellesley Hospital in Massachusetts, and colleagues conducted a randomized, double-blind, placebo-controlled study of 64 participants with ankle osteoarthritis. An active group of 39 patients received a 2.5-mL injection of low-molecular-weight, non-cross-linked sodium hyaluronate solution (Supartz), while 25 patients in a control group received a 2.5-mL injection of normal saline solution. For each patient, researchers assessed American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analog pain scale (VAS), and Ankle Osteoarthritis Scale (AOS), at baseline and at weeks six and 12.

The researchers found that mean AOFAS scores improved from baseline by 4.9 points at week six and by 4.9 points at week 12 in the active group, while they declined by 0.4 points at six weeks and then improved by 5.4 points at 12 weeks in the placebo group. Mean AOS scores for the active group improved by 5.0 points at week six and 5.3 points at week 12, while the placebo group's scores improved by 8.4 and 14.8 points, respectively. Mean VAS pain scores in the active group improved from baseline by 6.4 points at week six and 4.1 points at week 12, while the placebo group's scores improved by 3.0 and 11.1 points, respectively. In the three categories assessed, differences in outcomes between the groups were not considered significant.

"On the basis of our data, we can conclude that, in the ankle, a single injection of low-molecular-weight, non-cross-linked hyaluronic acid of the type we studied is not superior to a single injection of saline solution for the treatment of arthritis," the authors write. "Different dose regimens and different hyaluronic acid products deserve further study; however, entirely new types of nonsurgical treatments for ankle osteoarthritis are also needed."

One or more authors disclosed receiving compensation from third parties supporting some aspect of this work.

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