Nonanimal Hyaluronic Acid for the Treatment of Ankle Osteoarthritis: AProspective, Single-Arm Cohort Study

Abstract

Ankle osteoarthritis (OA) can cause disabling symptoms, and some patients prefer to be treated with minimally invasive procedures. Nonanimal hyaluronic acid (NASHA) is a cross-linked hyaluronic acid product that has a prolonged intra-articular residence time. The authors report the first study of NASHA for the treatment of ankle OA. Thirtyseven patients with Kellgren-Lawrence grade II or III ankle OA received an intra-articular injection of NASHA (1 mL). Outcomes included visual analogue scale (VAS) scores for pain and disability. At baseline, the mean VAS pain score was 50.1 § 14.5 mm. During the 26-week follow-up period, the least squares (LS) mean change from baseline in the ankle OA VAS pain score was −20.5 mm (95% confidence interval [CI] ¡25.5 to ¡15.6 mm), an LS mean percentage reduction of 40.0% (95% CI 30.2% to 49.9%). The LS mean change from baseline in the VAS disability score during 26 weeks was ¡19.2 mm (95% CI ¡24.8 to ¡13.6 mm), a percentage reduction of 34% (95% CI 22.3% to 45.7%). Five participants experienced a total of 7 adverse events considered to be related to study treatment (injection site pain, n = 3; injection site joint pain, n = 3; plantar fasciitis, n = 1). This study shows promise for viscosupplementation with NASHA in the treatment of ankle OA. A single injection was associated with clinically meaningful reductions in pain and disability during a 26-week period and, in general, was well tolerated.

Injection Techniques for Common Chronic Pain Conditions of the Foot: A Comprehensive Review

“…Currently, there are a total of 18 studies assessing the effectiveness of IA injections of HA in the treatment ankle OA, seven RCTs, nine case series, and two prospective cohort studies [73,78]. Each case series and the two prospective cohort studies concluded that intra articular HA was an effective and tolerable in the treatment of osteoarthritic ankle pain, with some studies noting pain relief for up to 12--18 months following injection [73,78]. All seven RCTs concluded that intra-articular HA injections lead to significant relief of ankle pain.…”

The Use of Injection Methods for the Prevention and Treatment of Post-Traumatic Osteoarthritis of the Ankle Joint (Literature Review)

“…Серед загальних побічних явищ після введення ГК описують головний біль, артралгію, назофарингіт тощо [31].…”

Engineering of Viscosupplement Biomaterials for Treatment of Osteoarthritis: A Comprehensive Review

“…[ 98 ] Nevertheless, despite the considerable interest in these products, many studies in the clinical stage also combine this with other drugs such as dexamethasone, hexacetonide, mannitol, and botulin toxin, among others, as well as the use of other innovative products that are described in Table 2. [ 96–106 ]…”

“…[98] Nevertheless, despite the considerable interest in these products, many studies in the clinical stage also combine this with other drugs such as dexamethasone, hexacetonide, mannitol, and botulin toxin, among others, as well as the use of other innovative products that are described in Table 2. [96][97][98][99][100][101][102][103][104][105][106] When a team takes their product into clinical trials, there are unavoidable safety concerns and issues to consider. These are first 1) transversal to all clinical products and then 2) those associated with the product itself have to be weighed.…”