Related Experiment Video
Updated: Jun 7, 2026
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Intra-articular sodium hyaluronate injections in the osteoarthritic ankle joint: effects, safety and dose dependency
Angelique G H Witteveen1, Inger N Sierevelt, Leendert Blankevoort
1Afdeling Orthopedie, St. Maartenskliniek, Hengstdal 3, P.O. Box 9011, 6500 GM Nijmegen, The Netherlands. a.witteveen@maartenskliniek.nl
Background:
To determine the efficacy, safety and dose dependency of intra-articular Orthovisc(®) hyaluronic acid injections in the ankle.
Methods:
A prospective single blinded study in patients with symptomatic ankle-osteoarthritis. Patients were randomly allocated to 1, 2, 3 ml, or 3 weekly injections of 1 ml (3 × 1 ml). Primary outcome was 'pain during walking' at 15 weeks measured on a 100mm VAS.
Results:
Twenty-six patients (ITT) participated. The 3 × 1 ml dose group showed statistically significant decreases at week 7 for 'pain during walking' and 'pain at rest' (p=0.046). At week 15 decreases were significant for 'pain at rest' (p=0.046). There was no significant decrease of VAS-scores in any of the single dose groups. Seven patients experienced temporary local swelling and increased pain in the injected ankle.
Conclusions:
Orthovisc(®) viscosupplementation in the ankle joint is effective and well tolerated. The 3 × 1 ml dose regimen shows the best results.
