Use of viscosupplementation for the recovery of active football players complaining of knee pain

Abstract

ObjectiveThe aim of this study is to investigate the effect of intra-articular hyaluronic acid administration in active football players complaining of knee pain after sports activity. Efficacy and safety profiles of intra-articular hyaluronic acid and time needed for football players to recover and restart sports activity were examined.MethodsClinical data of active football players reporting knee pain after sports activity were included in this retrospective study. All patients who received an intra-articular injection at time 0 and after 2 weeks were included in the study. Patients underwent laboratory examination, knee X-ray, ultrasound, and clinical examination before receiving the intra-articular injection. Effusions or cysts were drained before injections. Lequesne index score, pain visual analog scale (VAS) score, and patient’s global assessment score were recorded at time 0 (day of the first injection), 1 and 2 days after the first injection, at 2 weeks (day of the second injection), and at follow-up visits. Only data from patients completing the follow-up were analyzed.ResultsData from 17 patients were analyzed: 16 males and one female, of which three were professional players (two males and one female) and 14 were nonprofessional players. The mean age of patients was 39.8±11.8 years. Two patients (one male and one female) showed joint effusion. Two patients reported relevant joint pain after injection that regressed without any medication. At the first week, all parameters examined indicated improvement that was maintained until the end of follow-up. One day after the first and second injection, patients reported a slight increase in pain VAS score, which was not statistically significant, and the pain resolved after 1 day. All patients successfully restarted playing after the first injection within 3.1±2.0 days and kept playing after the second injection following our indication (1 day of break).ConclusionThe use of a medium-molecular weight hyaluronic acid in football players affected by knee osteoarthritis seems efficacious and safe and resulted, in our experience, a stable improvement of symptoms; moreover, it allowed a rapid restart of sports activity. Larger studies on larger populations are needed to confirm these findings.

Intra-articular hyaluronic acid injections and oral collagen supplementation for knee OA: A case report of an elite female soccer player

“…Professional soccer players are very susceptible to articular cartilage damage and early development of OA because of the repetitive high-level impact, stress and trauma due to running, jumping, acceleration, kicking and direction changing (Lane et al, 1993;Papalia et al, 2016). Hyaluronic acid for knee OA to relieve the pain caused by joint degeneration or injury represents a common therapeutic option method for most patients and athletes (Migliore et al, 2018;Wu et al, 2017). Anyway, the use of IA-HA in active sports players remains a controversial issue (Migliore et al, 2018).…”

“…The use of intra-articular hyaluronic acid has not been reported for professional athletes, so data regarding the use of hyaluronic acid in professional athletes are still lacking (Migliore et al, 2018). Furthermore, to our knowledge no studies evaluated the effects of IA-HA injections in female soccer players.…”

“…Several studies have reported that up to 19-29% of soccer players develop OA, which seriously affects their careers (Drawer and Fuller, 2001). Active soccer players may experience a limitation in their activity due to knee pain, especially after sporting activity (Migliore et al, 2018). Athletes affected by knee pain usually continue practicing their sports, often with difficulties and decrease in quality of performance (Migliore et al, 2018).…”

“…Active soccer players may experience a limitation in their activity due to knee pain, especially after sporting activity (Migliore et al, 2018). Athletes affected by knee pain usually continue practicing their sports, often with difficulties and decrease in quality of performance (Migliore et al, 2018). Therefore, the prevention of knee injuries, the maintenance of knee joints and the early detection and diagnosis of knee OA are crucial for soccer players (Elleuch et al, 2008;Takeda et al, 2011;Tarantino and Brancaccio, 2019;Wu et al, 2017).…”

“…© 2021 University of Alicante several studies have reported how in the hours or days following the intra-articular injection of hyaluronic acid some patients may experience a transient pain in the injected joint (Miller and Block, 2013). Usually, this pain is reported as transient and regresses without any need of medications (Migliore et al, 2018).…”