Hyaluronic Acid Instillation following Arthroscopic Anterior Cruciate Ligament Reconstruction: A Double-Blinded, Randomised Controlled Study

Abstract

purpose. To assess the effect of hyaluronic acid instillation after arthroscopic anterior cruciate ligament (ACL) reconstruction for improving pain, range of movement, and function of the knee. Methods. 28 men and 4 women underwent arthroscopic ACL reconstruction for isolated ACL rupture (partial or complete) and instability after recreational sports injury 2 to 120 months earlier.They were randomised to undergo arthroscopic ACL reconstruction followed by intra-articular viscoseal instillation (13 men and 3 women) or arthroscopic ACL reconstruction alone (15 men and 1 woman). The knee injury osteoarthritis outcome score (for pain, symptoms, activities of daily living, sport and recreation function, and quality of life), range of movement, knee circumference, and analgesic use were assessed on days -1, 1, and 2, and weeks 2, 6 and 12. results. Patient demographics were similar at baseline. At postoperative days 1 and 2, all subscales Hyaluronic acid instillation following arthroscopic anterior cruciate ligament reconstruction: a double-blinded, randomised controlled study Jackie YM Chau,

Efficacy of hyaluronic acid after knee arthroscopy: A systematic review and meta-analysis

“…Exogenous hyaluronic acid was reported to stimulate de novo synthesis of hyaluronic acid, and inhibit the release of arachidonic acid and interleukin-1αinduced prostaglandin E 2 synthesis, which reduced the anti-inflammatory response for pain control (35). One included RCT reported that hyaluronic acid treatment was capable of substantially alleviating pain and symptoms within 2 days after arthroscopic anterior cruciate ligament reconstruction (18). Another RCT also reported that statistically significant pain reduction was found one week postoperatively in arthroscopic surgery (26).…”

“…Exogenous hyaluronic acid injected into the arthritic joint space has been shown to improve the qualitative and quantitative properties of endogenous hyaluronic acid and therefore improve joint lubrication (17). In a randomized controlled study (RCT), intra-articular hyaluronic acid was reported to improve pain control and swelling after arthroscopic anterior cruciate ligament reconstruction (18).…”

I.S.Mu.L.T. Hyaluronic acid injections in musculoskeletal disorders guidelines

“…Early viscosupplementation in arthroscopic partial meniscectomy was found to have conflicting results and a possible improvement in short-term pain is not showed in all level I studies [178][179][180] . Different studies on viscosupplementation after ACL reconstruction evidenced inflammation, swelling and pain reduction only in the immediate post-operative period, without any difference in the longterm 69,181,182 . Conversely, three RCTs showed significant pain and clinical scores improvement for HMW HA after knee arthroscopy in knee OA [183][184][185] .…”

Viscosupplementation for Management of Knee Osteoarthritis from an Indian Perspective: An Expert Consensus Report

“…The following are important considerations for IAHA instillation following arthroscopic surgery:Patients with persistent knee pain following arthroscopy [26]Patients with mild knee OA who have undergone arthroscopic partial meniscectomy and debridement [27]…”

“…Patients with mild knee OA who have undergone arthroscopic partial meniscectomy and debridement [27]…”