Objective: Our purpose was to assess the effect of a new hyaluronic acid-based (Hymovis®) injections on joint space width narrowing in patients diagnosed with knee osteoarthritis. Methods: A prospective clinical trial was conducted in the Department of Orthopedics and Traumatology II from the Clinical County Hospital, Tîrgu Mureș, Romania. Thirty-five patients diagnosed with idiopathic knee osteoarthritis received two intraarticular injections with hyaluronic acid-based hydrogel (24 mg of hyaluronic acid/3 ml) at one-week interval. Anteroposterior radiographs were obtained before the injections, at six and twelve months after. Minimum joint space width was measured by two senior orthopaedics surgeons at each follow up. Each radiograph was measured again by the same evaluators two weeks apart. Results: Thirty-one patients were present at the final follow-up. A minor reduction in mean weight was noticed (from 82.2 kg ± 16.2 kg to 80.9 kg ± 16.0, p > 0.398) without any correlation with joint space width narrowing. There were no major changes at the first follow up (6 months) regarding joint space narrowing. A reduction in joint space width was observed however at 12 months varying from 4.4 mm (SD ± 1.64, range 1.8-7.1) at the first assessment to 4.3 mm (SD ± 1.26, range 0.0-6.8) at the final follow-up but with no statistical difference (p=0.237). Conclusion: No significant modification in joint space width at the final follow-up secondarily proved that two injections of Hymovis® may slow down narrowing in the knee joint space over a one-year period.

Background: Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure and considered to be the gold standard in restoring knee function and stability in ACL-deficient knees. The TransLateral all-inside technique implies the use of only two portals – anterolateral and anteromedial, without the use of an accessory portal. The work is done using the lateral portal, while the medial portal serves as a viewing site. Only a few studies have been published regarding the assessment of the functional and clinical outcomes of this novel technique. Aim of the study: To determine the clinical effectiveness of the TransLateral procedure used for ACL reconstruction and its ability to re-establish joint functionality and stability in ACL-deficient knees. Material and methods: A prospective study was conducted at the Orthopedics and Traumatology Clinic no. 2 in Tîrgu Mureș. Thirty-two patients matched our inclusion criteria and were operated using the TransLateral technique for ACL reconstruction. Outcome assessment was performed using the Knee injury and Osteoarthritis Outcome Score (KOOS), the Lysholm score and the Tegner Activity Scale. The questionnaires include items referring to pain, physical functioning, sports activities, and quality of life. Operative time and ACL graft size were also documented. Results: All patients underwent single-bundle ACL restoration using a quadrupled semitendinosus tendon. Out of 32 patients, 21 had associated meniscus lesions and 8 collateral ligament injuries. Mean graft diameter was 8.7 mm and mean length 63.2 mm. Significantly improved KOOS values were found at 12 months post-surgery regarding the mean baseline score: 59.3 ± 5.3 vs. 95.3 ± 4.9, p <0.0001. The Lysholm score improved from a mean of 56.3 ± 4.9 to 93.9 ± 5.6, p <0.0001 at the end-point. The Tegner activity scale ranged from 3.8 ± 1.9 to 5.9 ± 2.4, p <0.0001 at the final follow-up. Conclusions: The TransLateral technique proved its clinical effectiveness and its ability to restore knee stability after ACL reconstruction surgery.

Objective: To determine the influence of a new intraarticular hyaluronic acid based hydrogel (Hymovis®) injections on the amount of analgesics consumption in patients diagnosed with primary knee OA. Methods: A prospective, single-center study that included 35 patients, aged 45-80 years was conducted in our orthopaedics department. Patients received two intraarticular injections of hyaluronic acid (24 mg/3 ml; 500-730 kDa; Hymovis®) at one week apart. Follow-up was scheduled at 2 and 6 months after the injections. Assessment tools included Visual Analogue Scale (VAS) and an in-house designed questionnaire regarding analgesic consumption (quantity, period and product) during the follow-up. Results: Compared to baseline, a significant amelioration in visual analogue scale was observed at six months' follow-up (74.2mm ± 11.7 vs. 57.3mm ± 12.1; p < .0001). 28% (n=10) of the patients reduced their total analgesic consumption at two months after the injections. At final follow-up, the analgesic intake was reduced by more than 50% in almost every case. Conclusions: Intraarticular administered injections with a novel hyaluronan-based hydrogel (Hymovis®) may reduce the amount of analgesic consumption and self-reported pain intensity in patients with knee OA.