Effects of repetitive injections of hyaluronic acid on peritendinous adhesions after flexor tendon repair: a preliminary randomized, placebo-controlled clinical trial

• Published in: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES Vol. 18; no. 1; pp. 11 - 17
• Main Authors: Ozgenel, Güzin Yeşim, Etöz, Abdullah
• Format: Journal Article
• Language: English
• Published: Turkey 01.01.2012
• Subjects: Adult; Arthroscopy; Double-Blind Method; Female; Finger Injuries - surgery; Humans; Hyaluronic Acid - administration & dosage; Injections; Male; Range of Motion, Articular; Tendon Injuries - surgery; Tissue Adhesions - prevention & control; Treatment Outcome; Viscosupplements - administration & dosage; Young Adult
• ISSN: 1306-696X; 1307-7945
• DOI: 10.5505/tjtes.2012.95530

The aim of this study was to investigate the efficacy of three injections of hyaluronic acid (HA) versus placebo (saline) over a two-week period on functional outcomes after zone-II flexor tendon repairs. Twenty-two patients with isolated zone-II flexor tendon injury of the index fingers were included in this study. Before tenorrhaphy, fingers were randomly divided into two groups; 11 were treated with three injections of HA around the tenorrhaphy site and 11 served as a placebo group and were treated with saline in the same way. The first dose was given at the time of tenorrhaphy and two additional doses were given at one-week intervals. A Kleinert rehabilitation protocol was employed postoperatively. Range of motion was assessed with total active and passive movement evaluation systems at 3 weeks, 3 months and long-term. Functional outcome was evaluated using the Strickland classification. There were no differences between the two groups in terms of range of motion at 3 weeks. However, at 3 months and long-term, a significant improvement was observed in fingers treated with HA compared to placebo. This preliminary placebo-controlled study suggests that repetitive injections of HA can improve clinical outcomes presumably due to the effect on decreasing adhesions in primary tendon repairs.