Intra-Articular Injection of Hyaluronic Acid Is Not Effective for the Treatment of Post-traumatic Osteoarthritis of the Elbow

Purpose: In this study we evaluated the effect and safety of intra-articular injection of hyaluronic acid in 19 consecutive elbows with post-traumatic osteoarthritis. Methods: In 18 patients (10 male and 8 female patients; mean age, 45.6 years [SD, 15.0 years]), 3 injections of sodium hyaluronate were given within 4 weeks at regular intervals. Evaluation took place just before the first injection, as well as after 3 and 6 months, and consisted of the Elbow Function Assessment Score, the Functional Rating Index of Broberg and Morrey, and the Modified Andrews Elbow Scoring System. Pain was also assessed by means of visual analog scales. Results: Viscosupplementation resulted in slight, short-term pain relief and a very limited decrease in activity impairment at evaluation after 3 months. After 6 months, no beneficial effects were noticed in any of the 19 injected elbows. Other parameters were not influenced by treatment with viscosupplementation at any time. Systemic or local adverse effects did not occur. Conclusions: Because the use of viscosupplementation for the treatment of post-traumatic osteoarthritis of the elbow provides only slight, short-term pain relief and a very limited decrease in activity impairment and the other parameters were not modified, we believe that viscosupplementation is not suitable for this indication. Level of Evidence: Level IV, therapeutic case series.