Efficacy of Intra-articular Hyaluronic Acid Injection in Early Stage Ankle Osteoarthritis

Abstract

Purpose: This study evaluated the efficacy of an intra-articular injection of sodium hyaluronate in the treatment of early stage osteoarthritis of the ankle.

Materials and Methods : Early stage ankle osteoarthritis (Takakura stage I and II) patients who received hyaluronic acid injection therapy were retrospectively reviewed. Patients underwent intra-articular injections of 2 mL of sodium hyaluronate for 3 consecutive weeks. Clinical evaluation and Visual Analogue Scale (VAS) scoring were performed at every three months after treatment.

Results: Total 27 patients were involved and mean age was 55 year old (range 33 to 77 years). There were 13 male and 14 female patients. Mean follow up duration was 13 month and. Pre-intra-articular VAS score was 8.9±0.7 and three month follow up score was 3.8±2.8. VAS score of last follow up was 3.2±3.4. The effect of hyaluronic acid continued about one year when analyzed the VAS score change of the patients followed for more than one year. Patients’ satisfaction was “very satisfied” in nine, “satisfied” in 12, “fair” in one, and “not satisfied” in five patients. Overall satisfaction rate was 82%. There were no ankle osteoarthritis stage changes in serial follow up radiograph.

Conclusion: Symptomatic relief of signs and symptoms of osteoarthritis of the ankle was achieved by injection of an intra-articular hyaluronate injection. Efficacy of Hyaluronate acid injection persisted more than 1 year in our study. Intra-articular hyaluronate injection to ankle osteoarthritis is safe and effective as knee joint and should be considered as a valid conservative treatment for ankle osteoarthritis.