Hyaluronic acid may not protect against early cartilage injury in runners
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Investigators found increased T2 and T1 relaxation times in marathon runners, a finding which they noted demonstrated early cartilage injury. Intra-articular hyaluronic acid compared with normal saline did not significantly impact relaxation times in all knee areas.
Researchers randomized 20 runners to receive either an intra-articular injection of hyaluronic acid (HA) or normal saline 1 week before they ran a marathon. There were 15 runners who completed the study, of which eight runners received HA and seven runners received normal saline. Investigators obtained baseline 3-T knee MRI prior to the marathon and at 48 to 72 hours and 3 months after the marathon, follow-up 3-T MRI scans were obtained. Investigators measured the T2 and T1 relaxation times of articular cartilage in eight locations which included the medial and lateral compartments and the patellofemoral joint. The changes in T2 and T1 relaxation times were compared between the treatment groups from baseline to immediate and 3-month post-marathon scans.
Results showed that after the marathon, there were no gross morphologic MRI changes. Investigators noted one patient who received normal saline had a vasovagal episode after injection and one patient who received HA reported patellofemoral pain at the 1-week MRI examination in the post-marathon period.
No statistically significant changes were seen in post-marathon studies in all articular cartilage areas of the knee on both the T2 and T1 relaxation times between the treatment groups. T1 values in the patellar and trochlear decreased below baseline in patients who received HA at 3 months, while patients who received normal saline saw persistent elevation above baseline values. – by Monica Jaramillo
Disclosures Nathani reports education support from Smith & Nephew and a grant from Linvatec. Please see the study for all other authors’ financial disclosures.
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