Frequently Asked Questions

A couple of years ago, I had some injections into my knee to help lubricate it. Saved me having surgery. My ankle is starting to bother me now. Can I have these same injections to the ankle?

Scientists are just beginning to investigate the use of hyaluronate injections to treat ankle osteoarthritis. The procedure is referred to as viscosupplementation. The injection helps restore the normal flow of fluid inside the joint. It is a joint lubricant. The natural result is to reduce pain and improve motion and function. As you know from personal experience, viscosupplementation of this type with hyaluronate has been done successfully with the knee. After three to five (once a week) injections, patients report considerable relief from pain. And with pain relief and improved ability for the joint to slide and glide comes a return in the ease of motion. These researchers wondered how well does this technique work for the ankle? They gave each of 50 patients with ankle arthritis in one ankle one injection every week for three weeks. Then they measured results one to six months after the last injection. Standardized tests of pain, motion, and balance were completed. Patients were asked to rate their level of satisfaction. Complications and use of pain relievers were also recorded. The results were very encouraging. Patients improved in all areas, used less pain medication, and rated their satisfaction high. There were no serious side effects either! In particular, the improvement in balance was consistent when measured with four different tests. The possibility of fewer falls and reduced risk of additional injuries are added benefits of viscosupplementation. There is also a cost savings in not having the expense of surgery. All positive changes occurred within the first month following the injections. And the benefits remained when patients were checked at the end of six months. Younger patients (55 years old and younger) seemed to improve more than older adults. The authors concluded that the use of hyaluronate injections for ankle osteoarthritis is safe and effective. Further studies are needed as this was the first one published in the area of viscosupplementation for ankle arthritis. It wouldn't hurt to talk with your physician about your ankle. Caught early enough, there may be other forms of conservative (nonoperative) care that could benefit you now.

Shu-Fen Sun, MD, et al. The Effect of Three Weekly Intra-Articular Injections of Hyaluronate on Pain, Function, and Balance in Patients with Unilateral Ankle Arthritis. In The Journal of Bone and Joint Surgery. September 21, 2011. Vol. 93-A. No. 19. Pp. 1720-1726.

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