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HA injection can be considered a safe and effective,
adjunctive treatment for short-term pain releif and functional improvement for ankles and feet of RA patients.
Rheumatoid arthritis (RA) cause pain and inflammation in
the affecting joints. The study mentioned here was performed to reveal whether
hyaluronic acid (HA) injection into rheumatoid arthritis ankles and feet can
achieve improvement in foot function and lessen synovial hyper-vascularization.
A total of 44 patients suffering from RA having unilateral
or bilateral painful ankle and foot involvement (N = 75) were studied. All the patients were randomized to obtain HA
(N = 40) or lidocaine (LI) (N = 35) injection at 2-week intervals.
At baseline, 4 weeks (first evaluation) and 12 weeks (secondary evaluation),
the clinical estimation was performed via a visual analog scale (VAS) and foot
function index (FFItotal) including subscales of pain (FFIpain) before
injection. The color Doppler ultrasound (CDUS) and synovitis scores were used
for the imaging evaluation performed concurrently. At the first evaluation, HA
injection improved the VAS score (p = .009),
FFIpain (p = .041), and
FFItotal(p = .032) considerably more
than LI injections. At the first evaluation (p = .005) and secondary evaluation (p < .001), the CDUS values decreased notably compared with
the base line values. The CDUS values of more than half of the joints
(54%, p = .042) were reduced due
to HA injections while the control group
displayed no change (20%, p = .56).
Although, HA injection did not decrease the CDUS values more than LI injection
did. No noteworthy difference was observed between or within the groups in the
synovitis scores concerning the evaluation of synovial hypertrophy.
Improvement was observed in foot function and pain
reduction due to HA injection. HA injection may have a modest consequence in
reducing synovial hyper-vascularization. Further large-scale study are needed
to confirm this outcome.
Modern rheumatology
Short-term effect of ultrasound-guided low-molecular-weight hyaluronic acid injection on clinical outcomes and imaging changes in patients with rheumatoid arthritis of the ankle and foot joints. A randomized controlled pilot trial
Chien-Chih Wang et al.
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