EFFECT OF INTRA-ARTICULAR INJECTION OF SODIUM HYALURONATE ON RECOVERY AFTER ARTHROSCOPIC KNEE SURGERY

Authors: S Anand et al.

References: Osteoarthritis & Cartilage 2004; 12(Suppl B)

Abstract
Aim: To determine effect of single post-operative injection of Sodium Hyaluronate (Viscoseal) on the pain and joint function, following arthroscopic knee surgery.

Method: Study design: A randomized, prospective, controlled, double blinded trial after ethical approval. Study procedure: Consenting patients (age group 18-60 years) undergoing arthroscopic knee surgery were randomized to either study group or control group, after the completion of their operation. Control group had 10ml of 0.5% Bupivacaine injected in the joint after the procedure, while study group had 10ml of Viscoseal (Sodium Hyaluronate preparation devoid of animal protein) injected in the joint. Patients were given questionnaires to assess their pain and function at various times (preoperatively; 2hr before surgery; Day 1, Day 7, 3 weeks and 6 weeks following surgery). Primary efficacy parameters used were Pain visual analogue scores at rest, on movement and on weight bearing. Secondary efficacy parameters used included WOMAC questionnaire, SF-12 general health questionnaire and use of rescue medication. Patients were evaluated clinically at 6 weeks by a blinded physiotherapy.

Results: Forty-eight patients (Average age 41 years, 20 females, 28 males) undergoing knee arthroscopy were randomized (24 patients each). The Hyaluronate group exhibited markedly lesser degrees of immediate post-operative pain and swelling; reduced need for analgesics, and a significantly larger drop in WOMAC scores than the Bupivacaine (P<0.05). SF-12 scores and delayed pain VAS score improved by a comparable amount. In particular, those undergoing partial meniscectomy exhibited greater benefits with Hyaluronate. No complications were recorded in either of the groups.

Conclusion: Sodium Hyaluronate (Viscoseal) injections could be safely used following arthroscopic knee surgery, to facilitate patient’s recovery.