Efficiency of Hyaloglide® in the prevention of the recurrence of adhesions after tenolysis of flexor tendons in zone II: a randomized, controlled, multicentre clinical trial

Abstract

Hyaloglide is a hyaluronan-based gel based on a novel auto-crosslinked technology designed to reduce postsurgical adhesions. Its efficacy was assessed in a multicentred randomized controlled trial comparing the results of flexor tenolysis in zone 2 following failed flexor tendon repairs. In the control group a standard release was performed. In the treated group, Hyaloglide was applied into the flexor sheath and around the site of tenolysis. Forty-five patients, 19 controls and 26 treated with Hyaloglide, were enrolled in 13 centres. All the patients were evaluated at 30, 60, 90 and 180 days after surgery by testing Total Active Motion, Quick-DASH questionnaire and number of working days lost after surgery. Patients in the Hyaloglide group had a statistically better recovery of finger motion at all time intervals and returned earlier to work and daily activities. The use of Hyaloglide did not appear to increase the complication rate.

Hyaluronic acid and tendon lesions

“…By reducing the expression of proinflammatory factors, adding exogenous HA reduces the fragmentation of endogenous HA and stimulates synovial synthesis of endogenous HA 16,26,36 . Concerning the therapeutic protocol for HA injections for tendinopathies, comparatively to other recent treatments for these conditions, where post-injection rehabilitation could be crucial 44 , such as PRP for example 45 , only 1 or 2 injections alone are described for HA treatments [30][31][32][35][36][37][38][39] . However, comparatively to PRP treatments, where it exist a wide variability in the administered product 46,47 , the molecular weight and the concentration of HA are known 18 ; high molecular weight HA seems to have a better effect on tendons 18 in the short-term.…”

Ultrasound-guided percutaneous injection to treat de Quervain’s disease using three different techniques: a randomized controlled trial

“…The quickDASH score consists of a questionnaire enquiring about symptoms and ability to perform daily, recreational, and working activities. The score of the questionnaire ranges from 0 (none symptoms/no difficulty) to 100 (extreme symptoms/unable to perform) [18]. Full data regarding the baseline characteristics of our sample are reported in Table 1.…”

“…HA injection has been widely used in the treatment of different degenerative joint diseases [14][15][16]. Due to its viscoelastic and anti-inflammatory properties, HA has been previously used successfully in the trigger finger [17] and to prevent tendon adhesion after surgery [18]. To our knowledge, this approach has never been reported in the treatment of de Quervain's disease.…”

Reduction of Intra-Articular Adhesion by Topical Application of Daidzein Following Knee Surgery in Rabbits

“…Lots of methods are available for intra articular adhesion prevention such as hyaluronan derivative gel, administration of corticosteroid, mitomycin C application and arthroscopic lysis of adhesions (Jerosch & Aldawoudy, 2007;Liu et al, 2008;Riccio et al, 2010). But intra articular adhesion was not able prevent by any of these methods completely.…”