%D 2007 %0 MEDLINE %T Periarticular hyaluronic acid in acute ankle sprain . %J Clin J Sport Med %V 17 %P 251-7 %A Petrella RJ %A Petrella MJ %A Cogliano A %M pub17620777 %X OBJECTIVES : To determine the efficacy and safety of periarticular hyaluronic acid injections in acute lateral ankle sprain during 9 months at a sports injuries center . DESIGN : Randomized controlled prospective trial SETTING : Primary sport medicine and emergency practice . PATIENTS : One hundred fifty-eight consecutive competitive athletes who suffered acute grade 1 or 2 lateral ankle sprains were randomized within 48 hours of injury . INTERVENTIONS : Patients were randomized at baseline to periarticular injection with hyaluronic acid ( HA ) + standard of care [ rest , ice , compression , and elevation ( RICE ) ] or placebo injection ( PL ) + standard of care ( RICE ) treatment at baseline assessment and on day 4 after injury . OUTCOMES MEASURES : Assessments at baseline and days 4 , 8 , 30 , and 90 included Visual Analogue Scale ( VAS ; 0-10 cm ) pain on weight bearing and walking 20 m , patient global assessment of ankle injury ( five-point categorical scale ) , patient satisfaction with treatment ( five-point categorical scale ) , time to return to pain-free and disability-free sport , and adverse events . Differences between groups were determined using an intent-to-treat analysis of variance . RESULTS : About 30% of the ankle sprains were "first" events , and no differences in clinical assessments with those presenting but not volunteering for the study ( n = 341 ) were observed . Time to intervention was 39 +/- 4 hours , with no difference between groups . No serious adverse events were recorded during the 8-day treatment period . No difference in concomitant treatment or physical therapy was observed between groups . A significant reduction in VAS pain on both weight bearing and walking was observed at day 8 for HA compared with PL ( P < 0 . 05 ) . Significantly greater patient satisfaction was observed for HA versus PL at days 4 ( P < 0 . 05 ) , 8 ( P < 0 . 001 ) , 30 ( P < 0 . 001 ) , and 90 ( P < 0 . 05 ) . Patient global assessment of ankle injury was significantly better compared with baseline in the HA group at day 8 , but this was not different between groups . Time to pain-free and disability-free return to sport was 11 ( +/-8 ) versus 17 ( +/-8 ) days for HA and PL , respectively ( P < 0 . 05 ) . CONCLUSION : HA treatment for acute ankle sprain was highly satisfactory in the short term and the long term versus PL . This was associated with reduced pain and more rapid return to sport , with few associated adverse events .