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

Knee Surg Sports Traumatol Arthrosc. 2006 Jan;14(1):32-9. doi: 10.1007/s00167-005-0625-x. Epub 2005 May 26.

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • 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
  • Knee Joint / 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

Substances

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