Viscosupplementation for the arthritic ankle.

Abstract

HA is, in large part, responsible for the viscoelastic properties of synovial fluid that are critical to normal joint function. In OA, the concentration and molecular weight of HA are diminished. The intra-articular injection of exogenous HA preparations, termed viscosupplementation, has been shown to be safe and efficacious for use in the treatment of OA of the knee. There seem to be many mechanisms of action in addition to the transient restoration of joint fluid viscoelastic properties. These include anti-inflammatory, anabolic, analgesic, chondroprotective, and anticatabolic effects. Anecdotal use in OA of the ankle has been encouraging, but larger scale, controlled studies need to be performed. In addition, long-term investigations will better define the duration of effectiveness that viscosupplementation provides and whether it is a cost-effective modality.