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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Research article

Use of hyaluronic acid injection after arthroscopic release in lateral patellar compression syndrome with degenerative cartilage changes: randomized control trial

Author: Sherwan A. Hamawandi

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Degenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes.

Method

Ninety patients age (30–50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intraarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months.

Results

There was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value< 0.001) with better improvement in Kujala score in group A after intra-articular injection of Hyaluronic acid up to 2 year of follow up (P-value = 0.006) as well as better improvement in visual analogue score at 6 months post-operatively (P-value = 0.035).

Conclusion

Intra-articular injection of Hyaluronic acid after arthroscopic release, in patients with lateral patellar compression syndrome and degenerative cartilage changes, can result in better improvement of knee pain and functional outcome up to 2 years of follow up.

Trial registration

NCT, NCT04134611. Registered 18 October 2019 -Retrospectively registered.

Mazzola C, Mantovani D. Patellofemoral malalignment and chondral damage: current concepts. Joints. 2013;1(2):27–33 Published 2013 Oct 24.PubMedPubMedCentral

Ficat P, Ficat C, Bailleux A. Syndrome d'hyperpression externe de la rotule (S.H.P.E.). son intérêt pour la connaissance de l'arthrose [external hypertension syndrome of the patella. Its significance in the recognition of arthrosis]. Rev Chir Orthop Reparatrice Appar Mot. 1975;61(1):39–59.PubMed

Fonseca LPRMD, Kawatake EH, Pochini AC. Lateral patellar retinacular release: changes over the last ten years. Rev Bras Ortop. 2017;52(4):442–9. Published 2017 Jun 15. https://doi.org/10.1016/j.rboe.2017.06.003.CrossRefPubMedPubMedCentral

Waisbrod H, Treiman N. Intra-osseous venography in patellofemoral disorders. A preliminary report. J Bone Joint Surg Br. 1980;62-B(4):454–6.CrossRef

Clifton R, Ng CY, Nutton RW. What is the role of lateral retinacular release? J Bone Joint Surg Br. 2010;92(1):1–6. https://doi.org/10.1302/0301-620X.92B1.22909.CrossRefPubMed

Elkousy H. Complications in brief: arthroscopic lateral release. Clin Orthop Relat Res. 2012;470(10):2949–53. https://doi.org/10.1007/s11999-012-2383-7.CrossRefPubMedPubMedCentral

Pagenstert G, Wolf N, Bachmann M, et al. Open lateral patellar retinacular lengthening versus open retinacular release in lateral patellar hypercompression syndrome: a prospective double-blinded comparative study on complications and outcome. Arthroscopy. 2012;28(6):788–97. https://doi.org/10.1016/j.arthro.2011.11.004.CrossRefPubMed

Lattermann C, Drake GN, Spellman J, Bach BR Jr. Lateral retinacular release for anterior knee pain: a systematic review of the literature. J Knee Surg. 2006;19(4):278–84. https://doi.org/10.1055/s-0030-1248120.CrossRefPubMed

Sanchis-Alfonso V, Montesinos-Berry E. Is lateral retinacular release still a valid surgical option? From release to lengthening. Ann Transl Med. 2015;3(19):301. https://doi.org/10.3978/j.issn.2305-5839.2015.11.15.CrossRefPubMedPubMedCentral

10.

Laurent TC, Laurent UB, Fraser JR. The structure and function of hyaluronan: an overview. Immunol Cell Biol. 1996;74(2):A1–7. https://doi.org/10.1038/icb.1996.32.CrossRefPubMed

11.

Seror J, Zhu L, Goldberg R, Day AJ, Klein J. Supramolecular synergy in the boundary lubrication of synovial joints. Nat Commun. 2015;6:6497. Published 2015 Mar 10. https://doi.org/10.1038/ncomms7497.CrossRefPubMedPubMedCentral

12.

Zhang W, Nuki G, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartil. 2010;18(4):476–99. https://doi.org/10.1016/j.joca.2010.01.013.CrossRef

13.

Gadek A, Kowiec K, Wordliczek J, Liszka H. Efficacy and safetyof intra-articular use of hyaluronic acid (Suplasyn) in the treatment of knee osteoarthritis. Przegl Lek. 2011;68(6):307–10.PubMed

14.

Das A, Neher JO, Safranek S. Clinical inquiries. Do hyaluronic acid injections relieve OA knee pain? J Fam Pract. 2009;58(5):281c.PubMed

15.

Migliore A, Granata M. Intra-articular use of hyaluronic acid in the treatment of osteoarthritis. Clin Interv Aging. 2008;3(2):365–9. https://doi.org/10.2147/cia.s778.CrossRefPubMedPubMedCentral

16.

Gupta RC, Lall R, Srivastava A, Sinha A. Hyaluronic acid: molecular Mechanisms and Therapeutic Trajectory. Front Vet Sci. 2019;6:192. Published 2019 Jun 25. https://doi.org/10.3389/fvets.2019.00192.CrossRefPubMedPubMedCentral

17.

Blanch Rubio J, Badstübner R, Schnee B, Martinek P. ASKOT study: effectiveness and safety of a 1-shot injection of sodium hyaluronate for knee osteoarthritis treatment. Springer Experience Drug Evidence. 2013;1:1–8.

18.

Linthoudt D, Gasser E. Evaluation of the analgesic efficacy and short-term tolerance of a single 6 ml injection of hyaluronic acid (Suplasyn® 1-shot) on osteoarthritis of the knee. DOLOR. 2013;28:89–92.

19.

Fosco M, Dagher E. Proposal of a therapeutic protocol for selected patients with patellofemoral knee osteoarthritis: arthroscopic lateral retinacular release followed by viscosupplementation. Musculoskelet Surg. 2016;100(3):171–8. https://doi.org/10.1007/s12306-016-0402-7.CrossRefPubMed

20.

Fulkerson JP. Diagnosis and treatment of patients with patel- lofemoral pain. Am J Sports Med. 2002;30:447–56.CrossRef

21.

Christoforakis J, Bull AM, Strachan RK, Shymkiw R, Senavongse W, Amis AA. Effects of lateral retinacular release on the lateral stability of the patella. Knee Surg Sports Traumatol Arthrosc. 2006;14(3):273–7. https://doi.org/10.1007/s00167-005-0699-5.CrossRefPubMed

22.

Chhabra A, Subhawong TK, Carrino JA. A systematised MRI approach to evaluating the patellofemoral joint. Skelet Radiol. 2011;40(4):375–87. https://doi.org/10.1007/s00256-010-0909-1.CrossRef

23.

Rodrigues MB, Camanho GL. MRI EVALUATION OF KNEE CARTILAGE. Rev Bras Ortop. 2015;45(4):340–6. Published 2015 Nov 17. https://doi.org/10.1016/S2255-4971(15)30379-7.CrossRefPubMedPubMedCentral

24.

Slattery C, Kweon CY. Classifications in brief: Outerbridge classification of Chondral lesions. Clin Orthop Relat Res. 2018;476(10):2101–4. https://doi.org/10.1007/s11999.0000000000000255.CrossRefPubMedPubMedCentral

25.

Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis. 1973;32(5):413–8. https://doi.org/10.1136/ard.32.5.413.CrossRefPubMedPubMedCentral

26.

Staheli LT, Corbett M, Wyss C, King H. Lower-extremity rotational problems in children. Normal values to guide management. J Bone Joint Surg Am. 1985;67(1):39–47.CrossRef

27.

Aglietti P, Insall JN, Cerulli G. Patellar pain and incongruence. I: Measurements of incongruence. Clin Orthop Relat Res. 1983;176:217–24.

28.

Batailler C, Neyret P. Trochlear dysplasia: imaging and treatment options. EFORT Open Rev. 2018;3(5):240–7. Published 2018 May 21. https://doi.org/10.1302/2058-5241.3.170058.CrossRefPubMedPubMedCentral

29.

Kolowich PA, Paulos LE, Rosenberg TD, Farnsworth S. Lateral release of the patella: indications and contraindications. Am J Sports Med. 1990;18(4):359–65. https://doi.org/10.1177/036354659001800405.CrossRefPubMed

30.

Nonweiler DE, DeLee JC. The diagnosis and treatment of medial subluxation of the patella after lateral retinacular release. Am J Sports Med. 1994;22(5):680–6. https://doi.org/10.1177/03635465940220051712.CrossRefPubMed

31.

Chen J, Chen D, Xiao Y, et al. Efficacy and experience of arthroscopic lateral patella retinaculum releasing through/outside synovial membrane for the treatment of lateral patellar compression syndrome. BMC Musculoskelet Disord. 2020;21:108. https://doi.org/10.1186/s12891-020-3130-y.CrossRefPubMedPubMedCentral

32.

Fithian DC, Paxton EW, Post WR. Panni AS; international Patellofemoral study group. Lateral retinacular release: a survey of the international Patellofemoral study group. Arthroscopy. 2004;20(5):463–8. https://doi.org/10.1016/j.arthro.2004.03.002.CrossRefPubMed

33.

Fu FH, Maday MG. Arthroscopic lateral release and the lateral patellar compression syndrome. Orthop Clin North Am. 1992;23(4):601–12.PubMed

34.

Astur DC, Angelini FB, Santos MA, Arliani GG, Belangero PS, Cohen M. Use of exogenous hyaluronic acid for the treatment of patellar Chondropathy- a six-month randomized controlled trial. Rev Bras Ortop (Sao Paulo). 2019;54(5):549–55. https://doi.org/10.1055/s-0039-1697974.CrossRef

Title: Use of hyaluronic acid injection after arthroscopic release in lateral patellar compression syndrome with degenerative cartilage changes: randomized control trial
Author: Sherwan A. Hamawandi
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-03876-0

At a glance: The STEP trials

Springer Medicine

Use of hyaluronic acid injection after arthroscopic release in lateral patellar compression syndrome with degenerative cartilage changes: randomized control trial

Abstract

Background

Method

Results

Conclusion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Results

Conclusion

Trial registration

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