PMID- 20048489
OWN - NLM
STAT- MEDLINE
DCOM- 20100226
LR  - 20100105
IS  - 0091-3847 (Print)
IS  - 0091-3847 (Linking)
VI  - 37
IP  - 1
DP  - 2009 Apr
TI  - Original research: long-term efficacy and safety of periarticular hyaluronic acid 
      in acute ankle sprain.
PG  - 64-70
LID - 10.3810/psm.2009.04.1684 [doi]
AB  - The objectives of this study were to determine the long-term efficacy and safety 
      of periarticular hyaluronic acid (HA) injections in acute lateral ankle sprain. A 
      randomized, controlled, prospective trial in a primary sports medicine and 
      emergency practice involved 158 competitive athletes who suffered an acute grade 
      1 or 2 lateral ankle sprain, and who were randomly assigned within 48 hours of 
      injury. Patients were randomly assigned at baseline to periarticular injection 
      with HA + standard of care (rest, ice, elevation, and compression [RICE]) or 
      placebo injection (PL) + standard of care (RICE) treatment at baseline assessment 
      and day 4 after injury. Follow-up was at 30, 90, and 712 days after treatment. 
      Assessments at baseline and days 4, 8, 30, 90, and 712 included visual analogue 
      scale (VAS) (0-10 cm) pain on weight bearing and walking 20 m, patient global 
      assessment of ankle injury (5-point categorical scale), patient satisfaction with 
      treatment (5-point categorical scale), time to return to pain-free and 
      disability-free sport, recurrent ankle sprain, total number of days missing from 
      primary sport activity, and adverse events (AEs). Time to intervention was 39 +/- 
      4 hours with no difference between groups. A significant reduction in VAS pain on 
      both weight bearing and walking was observed at all follow-up assessments for HA 
      compared with PL (P < 0.001). Time to pain-free and disability-free return to 
      sport was 11 (+/- 8) versus 17 (+/- 8) days for HA and PL, respectively (P < 
      0.05). At 24 months, in the PL versus HA group, there were 2 versus 0 lower limb 
      fractures, 16 versus 7 second ankle sprains (P < 0.05), 3 versus 1 third ankle 
      sprains, and a significantly greater number of days missing primary sport 
      activity (41 vs 21; P < 0.002). Significantly greater patient satisfaction was 
      also observed for HA versus PL at all follow-up assessments. No serious AEs were 
      recorded throughout follow-up. Periarticular HA treatment for acute ankle sprain 
      was highly satisfactory in the short and long term versus PL. This was associated 
      with reduced pain, more rapid return to sport, fewer recurrent ankle sprains, 
      fewer missed days from sport, and with few associated AEs to 24 months.
FAU - Petrella, Michael J
AU  - Petrella MJ
AD  - Department of Family and Physical Medicine and Rehabilitation, Schulich School of 
      Medicine, University of Western Ontario, London, Ontario, Canada. petrella@uwo.ca
FAU - Cogliano, Anthony
AU  - Cogliano A
FAU - Petrella, Robert J
AU  - Petrella RJ
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - England
TA  - Phys Sportsmed
JT  - The Physician and sportsmedicine
JID - 0427461
RN  - 0 (Placebos)
RN  - 0 (Viscosupplements)
RN  - 9004-61-9 (Hyaluronic Acid)
SB  - IM
MH  - Adult
MH  - Ankle Injuries/*drug therapy
MH  - Chi-Square Distribution
MH  - Female
MH  - Humans
MH  - Hyaluronic Acid/administration & dosage/*therapeutic use
MH  - Injections, Intra-Articular
MH  - Male
MH  - Pain Measurement
MH  - Placebos
MH  - Sprains and Strains/*drug therapy
MH  - Treatment Outcome
MH  - Viscosupplements/administration & dosage/*therapeutic use
EDAT- 2010/01/06 06:00
MHDA- 2010/02/27 06:00
CRDT- 2010/01/06 06:00
PHST- 2010/01/06 06:00 [entrez]
PHST- 2010/01/06 06:00 [pubmed]
PHST- 2010/02/27 06:00 [medline]
AID - 10.3810/psm.2009.04.1684 [doi]
PST - ppublish
SO  - Phys Sportsmed. 2009 Apr;37(1):64-70. doi: 10.3810/psm.2009.04.1684.