Effects of Viscoseal, a synovial fluid substitute, on recovery after arthroscopic partial meniscectomy and joint lavage.

Abstract

This was a pilot, single blind, randomised, controlled study in patients requiring partial meniscectomy. The aim was to assess whether replacing the synovial fluid lost during arthroscopy with a hyaluronic acid-containing synovial fluid substitute (Viscoseal) would reduce the severity and duration of post-operative symptoms during the 4 weeks post-surgery, in comparison to the standard arthroscopy procedure alone. Fifty patients were randomly assigned to either undergo arthroscopic partial meniscectomy alone (control group: n=25) or to receive 10 ml Viscoseal into the joint at the end of the procedure (Viscoseal group: n=25). Forty patients (20 per group) completed the study. Despite the small patient population in this pilot study, some interesting results were obtained. On Day 1 after surgery, the mean values for pain at rest (VAS) increased in both groups but this increase was lower in the Viscoseal group (8.9+/-23.1 mm) than in the standard therapy group (20.0+/-25.9 mm) (Mann-Whitney statistic MW-S: P=0.0525) and remained in favour of Viscoseal for the first 3 days after surgery. Joint swelling decreased to a greater extent in the Viscoseal group with an observed superiority at Day 7 (MW-S: P=0.1187) and a proven superiority at Days 12 (MW-S: P=0.015) and 28 (MW-S: P=0.0072). Diclofenac intake was lower in the Viscoseal group from Day 3 to Day 28 with a proven superiority (LB-CI > 0.5) in favour of Viscoseal on Days 3 (MW-S: P = 0.0093), 4 (MW-S: P= 0.0075), and 7 (MW-S: P = 0.0195) indicating that the product had an NSAID-sparing effect. Viscoseal was safe and well-tolerated and no adverse reactions occurred during the study. These findings indicate that Viscoseal may be useful as a synovial fluid substitute after arthroscopy.

• Authors: B Mathies
• Journal: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA (Knee Surg Sports Traumatol Arthrosc) Vol. 14 Issue 1 Pg. 32-9 (Jan 2006) ISSN: 0942-2056 [Print] Germany
• PMID: 15918064 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Adjuvants, Immunologic
• Anti-Inflammatory Agents, Non-Steroidal
• Viscoseal
• Diclofenac
• Hyaluronic Acid

Topics

• Activities of Daily Living
• Adjuvants, Immunologic (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Arthroscopy
• Diclofenac (therapeutic use)
• Edema (physiopathology)
• Feasibility Studies
• Female
• Humans
• Hyaluronic Acid (therapeutic use)
• Knee Joint (physiopathology, surgery)
• Male
• Menisci, Tibial (surgery)
• Middle Aged
• Pain Measurement
• Pain, Postoperative (prevention & control)
• Pilot Projects
• Recovery of Function
• Single-Blind Method
• Therapeutic Irrigation
• Treatment Outcome