Abstract
Osteoarthritis is a chronic disorder characterized by joint cartilage degeneration with concomitant changes in the synovium and subchondral bone metabolism. Many conservative treatment modalities, one of which is intra-articular injections, have been described for the treatment of this disorder. Traditionally, hyaluranic acid and corticosteroids are the agents that have been used for this purpose. Recently, polyacrylamide hydrogels are being used widely. Biocompatibility, nonbioabsorbability, and anti-infectious effect obtained by silver addition made polyacrylamide hydrogels more popular. In this paper, we present a case and the method of our management, in whom host tissue reaction (foreign body granuloma, edema, inflammation, and redness induration) has been observed, as the first and unique adverse effect reported in the literature.
Highlights
Osteoarthritis is a chronic, progressive disorder characterized by joint cartilage degeneration associated with concomitant changes in the synovium and subchondral bone metabolism [1]
Inra-articular hyaluronic acid (HA) injections have been recommended for osteoarthritis treatment [4, 5]
In particular after esthetic surgeries, transient surgical side pain, hematoma, irregularity, gel deposition, and asymmetry, tissue reactions including infection, foreign body granuloma, edema, inflammation, tenderness, and sensitivity, and adverse effects including gel migration and induration were very rarely reported [10]. In this case report we aim to present a case, in which relevant adverse effects followed the intra-articular treatment of knee osteoarthritis in a patient
Summary
Osteoarthritis is a chronic, progressive disorder characterized by joint cartilage degeneration associated with concomitant changes in the synovium and subchondral bone metabolism [1]. The main and first treatment modality of osteoarthritis is conservative treatments including acetaminophen, nonsteroidal anti-inflammatory agents, exercise, and weight loss; intra-articular injections are gaining more popularity in recent years. The decrease in intraarticular concentration and molecular weight of endogenous hyaluronic acid (HA) causes alterations in synovial fluid characteristics which in turn prompts cartilage degeneration and aggravations in symptoms [3]. Polyacrylamide hydrogels (PAH) have gained popularity in recent years, especially in Asia [6, 7]. It is a new treatment option; it should be critically investigated before treating our patients
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