Viscosupplementation in Ankle Osteoarthritis: A Systematic Review

Faleiro, Thiago Batista; Schulz, Renata da Silva; Jambeiro, Jorge Eduardo de Schoucair; Neto, Antero Tavares Cordeiro; Delmonte, Fernando Moreira; Daltro, Gildásio

doi:10.1590/1413-785220162401139470

Cited by 12 publications

(7 citation statements)

References 29 publications

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“…Unfortunately, the overall quality of the randomized controlled trials was low and the numbers of participants were limited. As reported by the authors of a systematic review of viscosupplementation for ankle OA, although there is some evidence of superiority of viscosupplementation versus saline control, there is no evidence of significant benefit versus exercise-based therapy (11).…”

Section: Discussionmentioning

confidence: 96%

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

Younger

Penner

Wing

et al. 2019

The Journal of Foot and Ankle Surgery

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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.

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Section: Discussionmentioning

confidence: 96%

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

Younger

Penner

Wing

et al. 2019

The Journal of Foot and Ankle Surgery

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“…Compared with previous attempts to investigate this field [6,85,86], the strengths of this meta-analysis included a more specific selection of patients affected only by ankle OA or OLT, excluding pathologies of different nature, such as rheumatoid arthritis and haemophilic arthropathy; single-arm analysis provided on HA and PRP; and the evaluation of the injection therapies for up to 12 months of follow-up. Finally, a quality assessment was performed, underlying the very low level of evidence of the studies and related findings.…”

Section: Discussionmentioning

confidence: 99%

Evidence on ankle injections for osteochondral lesions and osteoarthritis: a systematic review and meta-analysis

Boffa

Previtali

Frattura

et al. 2020

International Orthopaedics (SICOT)

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Purpose To evaluate the evidence supporting safety and effectiveness of intra-articular injective treatments for ankle lesions ranging from osteochondral lesions of the talus (OLT) to osteoarthritis (OA). Methods A systematic review and a meta-analysis were performed on PubMed, Embase, and Cochrane Library in March 2020. Safety was evaluated through the reported side effects and effectiveness through the scores used. The quality of the studies was assessed using the Cochrane Collaboration Risk of Bias 2.0 tool and the Downs and Black checklist. For each outcome, the quality of evidence was graded according to GRADE guidelines. Results Twenty-four studies (21 for OA, 3 for OLT) were included on hyaluronic acid (HA), platelet-rich plasma (PRP), saline, methylprednisolone, botulinum toxin type A (BoNT-A), mesenchymal stem cells (MSCs), and prolotherapy. No severe adverse events were reported. For OLT, a comparison was possible between HA and PRP showing no significant difference. For ankle OA, a significant difference favouring HA versus saline was documented at six months (p < 0.001). The GRADE level of evidence was very low. Conclusion This meta-analysis supports the safety of intra-articular treatment for ankle OA and OLT, while only a very low evidence supports the efficacy of HA in terms of better results versus placebo for the treatment of ankle OA, and other conclusions are hindered by the scarcity of the available literature. This urges further and stronger trials to specifically investigate potential and limitations of these different injective approaches for the treatment of OLT and ankle OA.Keywords Ankle . Intra-articular . Osteoarthritis . Osteochondral lesions of the talus (OLT) . Hyaluronic acid (HA) . Platelet-rich plasma (PRP)

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“…Faleiro и соавт. [78]. Авторы изучили данные 5 РКИ (n=170), в которых сравнивалась эффективность в/с ведения ГлК, плацебо и физиотерапии.…”

Section: рис 1 механизм действия экзогенной глкunclassified

Hyaluronic acid preparations in the treatment of osteoarthritis: is it clear to us?

Каратеев¹,

Погожева²,

Амирджанова³

et al. 2018

RJTAO

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Osteoarthritis (OA) is a progressive joint disease that causes persistent pain, limited joint function, disability, and loss of social activity. One of the most popular OA treatment options is intra-articular (I/A) hyaluronic acid (HA) injections. This procedure was introduced into clinical practice in the early 1980s and is used universally. To date, there is no consensus on the therapeutic value of HA. Many investigations confirm that HA is effective as not only a symptomatic agent, but also a structure-modifying one. Some works also show that the effect of HA is equal or only slightly superior to that of placebo (I/A saline injection). The review describes the mechanism of action and comparative efficacy of various (lowand high-molecular weight) HA preparations, as well as the safety of their use in real clinical practice.

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Viscosupplementation in Ankle Osteoarthritis: A Systematic Review

Cited by 12 publications

References 29 publications

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

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

Evidence on ankle injections for osteochondral lesions and osteoarthritis: a systematic review and meta-analysis

Hyaluronic acid preparations in the treatment of osteoarthritis: is it clear to us?

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