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International Orthopaedics

, Volume 43, Issue 11, pp 2437–2445 | Cite as

Prevention of post-traumatic osteoarthritis after intra-articular knee fractures using hyaluronic acid: a randomized prospective pilot study

  • Ahmed Samir BarakatEmail author
  • Nour Muhamad Ibrahim
  • Osama Elghobashy
  • Ahmed Maher Sultan
  • Khaled F. M. Abdel-Kader
Original Paper

Abstract

Purpose

Based on the irreversible destruction of hyaline cartilage, post-traumatic osteoarthritis (PTOA) is a notorious sequelae after intra-articular knee fractures. This study evaluates the clinical efficacy and applicability of immediate post-operative intra-articular injection of hyaluronic acid (IA HA) into the knee joint with an intra-articular fracture.

Methods

Prospective randomized case-control study involving 40 patients (20 in each group) with intra-articular knee fracture with an average follow-up of 23 months (range 18–24 months). Twenty patients with intra-articular distal femoral or intra-articular proximal tibial fractures who met our inclusion criteria received three intra-articular hyaluronic acid injections weekly starting immediately after ORIF. Another 20 patients serving as a control group received no injection after ORIF. Patients were assessed functionally with Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) score. Plain X-rays and when indicated CT scans were used to assess radiological union.

Results

The results showed patients treated with intra-articular hyaluronic acid injection after fixation had significantly less pain (KOOS) (p = 0.01). No significant difference was found between both groups in other KOOS-related outcome measures, complications, functional outcome, or quality of life.

Conclusions

These preliminary results support a direct role for hyaluronic acid in the acute phase of the inflammatory process that follows articular injury and provides initial evidence for the efficacy of IA HA.

Keywords

Intra-articular injection after trauma Intra-articular hyaluronic acid injection Hyaluronic acid (HA) Post-traumatic osteoarthritis 

Notes

Compliance with ethical standards

This work was conducted at Cairo University Hospitals in accordance with the ethical standards of the Helsinki Declaration. All participating patients signed an informed consent regarding the procedure, possible complications, and alternative treatment modalities.

Conflict of interest

The authors declare that there is no conflict of interest.

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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Orthopedics and Trauma DepartmentCairo UniversityCairoEgypt
  2. 2.Orthopedics DepartmentSligo University HospitalSligoIreland

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