Acute Ischemic Stroke Associated With OrthoVisc (Hyaluronic Acid) Injection

Abstract

Hyaluronic acid (HA) is one of the main components of normal synovial fluid, acting as a shock absorber and a lubricant in the joints. When injected intra-articularly, the viscosupplementation of HA may potentially restore the biomechanical and biochemical functions of normal synovial fluid and may reduce the pain caused by osteoarthritis through anti-inflammatory, anabolic, analgesic, and chondroprotective mechanisms. HA has been approved by FDA as a medical device and has been used in patients with advanced osteoarthritis. Though it is usually safe and well tolerated, some local and systemic reactions can occur in rare cases. Here we report a 53-year-old man with severe osteoarthritis, who developed acute left cerebellar infarct after the injection of HA (OrthoVisc) preceded by symptoms of allergic reaction. Review of literature showed this is to date the first case of possible link between HA and ischemic stroke.