Intra-Articular Hyaluronic Acid Injection in Ankle Osteoarthritis

족관절 골관절염에서 히알루론산 관절 내 주사

  • Park, Yong-Wook (Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University School of Medicine)
  • 박용욱 (한림대학교 의과대학 강남성심병원 정형외과)
  • Received : 2011.07.30
  • Accepted : 2011.08.16
  • Published : 2011.09.15

Abstract

Treatment of osteoarthritis of the ankle joint is similar to that of any other large joint and includes conservative and surgical treatments. Surgical option in severe osteoarthritis is joint fusion or joint replacement, whereas conservative treatment is limited and includes mainly ankle supports, physical therapy, and oral medication. Hyaluronic acid was discovered in 1934 and now has been widely used in the knee and shoulder joints. We reviewed the articles about an intra-articular hyaluronic acid injection in the treatment of osteoarthritis of the ankle joint.

족관절 내 히알루론산 주사 후 효과에 대한 참고 자료를 살펴 본 결과 대부분의 연구들이 족관절 내 히알루론산 주사에 대한 효과와 안전에 대해 긍정적으로 보고하고 있지만, 아직까지는 결론을 짓기는 어렵다고 하겠다. 추후 많은 환자를 대상으로 한 무작위 이중맹검 위약대조군 연구(randomized double-blind placebo-controlled trials)를 통해 그 결과를 평가해야 할 것으로 사료되며, 또한 장기 추시를 통해 효과 발현 시기 및 지속 기간을 평가해야 할 것이다.

Keywords

References

  1. Creamer P, Hochberg MC. Osteoarthritis. Lancet. 1997;350:503-8. https://doi.org/10.1016/S0140-6736(97)07226-7
  2. Buckwalter JA, Mankin HJ, Grodzinsky AJ. Articular cartilage and osteoarthritis. Instr Course Lect. 2005;54:465-80.
  3. Watterson JR, Esdaile JM. Viscosupplementation: therapeutic mechanisms and clinical potential in osteoarthritis of the knee. J Am Acad Orthop Surg. 2000;8:277-84. https://doi.org/10.5435/00124635-200009000-00001
  4. Balazs EA, Denlinger JL. Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol Suppl. 1993;39:3-9.
  5. Rydell N, Balazs EA. Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of osteoarthritis and on granulation tissue formation. Clin Orthop Relat Res. 1971;80:25-32. https://doi.org/10.1097/00003086-197110000-00006
  6. Forrester JV, Balazs EA. Inhibition of phagocytosis by high molecular weight hyaluronate. Immunology. 1980;40:435-46.
  7. Stitik TP, Levy JA. Viscosupplementation (biosupplementation) for osteoarthritis. Am J Phys Med Rehabil. 2006;85(11Suppl):S32-50. https://doi.org/10.1097/01.phm.0000245677.20294.c2
  8. Smith MM, Ghosh P. Thesynthesis of hyaluronic acid by human synovial fibroblasts is influenced by the nature of the hyaluronate in the extracellular environment. Rheumatol Int.1987;7:113-22. https://doi.org/10.1007/BF00270463
  9. Marshall KW. Intra-articular hyaluronan therapy. Foot Ankle Clin. 2003;8:221-32. https://doi.org/10.1016/S1083-7515(03)00046-9
  10. Leopold SS, Redd BB, Warme WJ, Wehrle PA, Pettis PD, Shott S. Corticosteroid compared with hyaluronic acid injections for the treatment of osteoarthritis of the knee. A prospective, randomized trial. J Bone Joint Surg Am. 2003; 85:1197-203. https://doi.org/10.2106/00004623-200307000-00003
  11. Lee DH, Kim TH, Han SH. Efficacy of intra-articular hyaluronic acid injection in early stage ankle osteoarthritis. J Korean Foot Ankle Soc. 2011;15:27-31.
  12. Takakura Y, Tanaka Y, Kumai T, Tamai S. Low tibial osteotomy for osteoarthritis of the ankle. Results of a new operation in 18 patients. J Bone Joint Surg Br. 1995;77:50-4.
  13. Khosla SK, Baumhauer JF. Dietary and viscosupplementation in ankle arthritis. Foot Ankle Clin. 2008;13:353-61. https://doi.org/10.1016/j.fcl.2008.04.003
  14. Petrella RJ, Petrella M. A prospective, randomized, double- blind, placebo controlled study to evaluate the efficacy of intraarticular hyaluronic acid for osteoarthritis of the knee. J Rheumatol. 2006;33:951-6.
  15. Witteveen AG, Sierevelt IN, Blankevoort L, Kerkhoffs GM, van Dijk CN. Intra-articular sodium hyaluronate injections in the osteoarthritic ankle joint: effects, safety and dose dependency. Foot Ankle Surg. 2010;16:159-63. https://doi.org/10.1016/j.fas.2009.10.003
  16. Cohen MM, Altman RD, Hollstrom R, Hollstrom C, Sun C, Gipson B. Safety and efficacy of intra-articular sodium hyaluronate (Hyalgan) in a randomized, double-blind study for osteoarthritis of the ankle. Foot Ankle Int. 2008;29:657-63. https://doi.org/10.3113/FAI.2008.0657
  17. Salk RS, Chang TJ, D'Costa WF, Soomekh DJ, Grogan KA. Sodium hyaluronate in the treatment of osteoarthritis of the ankle: a controlled, randomized, double-blind pilot study. J Bone Joint Surg Am. 2006;88:295-302. https://doi.org/10.2106/JBJS.E.00193