Abstract
Trapeziometacarpal (TMC) joint osteoarthritis (OA) is a common disabling condition
in which the impact of visco-supplementation has to be ascertained. We aim to evaluate
the efficacy of high molecular weight hyaluronic acid (HA) ultrasound (US)-guided
intra-articular injection of TMC joints in OA. 32 TMC joints of 16 patients with symptomatic
thumb base OA were treated with three injections of high molecular weight HA at 1-week
intervals. Before injection, at week 0, 1, 2, and 24 all patients underwent clinical
and US examination. A significant clinical improvement was obtained by the decrease
in visual analog scale for pain after 2 weeks of treatment (p=0.0003) and this result is maintained at week 24 (p=0.009). The Dreiser’s index also decreased after week 2 and remain stable after 6
months. Power Doppler signal significantly decreased after 2 weeks of treatment (p=0.02), even if this result was not maintained at week 24. No significant decrease
in the synovial hypertrophy score was observed during the study. Our preliminary study
suggests that US-guided TMC injections by high molecular weight HA may be effective
in decreasing local inflammation and pain.
Keywords
Rhizarthrosis - Hyaluronic acid - Ultrasonography
