Effects of Hyaluronic Acid-Sorbitol formulation in Patients Undergoing Knee Arthroscopy: Effects on Pain and Articular Recovery

Background: Following non-bleeding arthroscopy, patients that are injected with 6 ml of hyaluronic acid (2%) and sorbitol (4%) formulation (Synolis VA) show better results in terms of pain reduction and improved mobility recovery compared to patients that did not receive the treatment. Introduction: Although there is no best irrigation solution for the knee arthroscopy, many studies showed that the common irrigation fluids, especially cold ones, are toxic for the articular chondrocytes, suppressing their metabolism and function. The purpose of this study is to evaluate the clinical outcome of patients injected with Synolis V-A after knee arthroscopy. Materials and Methods: 60 patients were randomly divided into 2 groups. At the end of the procedure 30 patients received an intra-articular injection of hyaluronic acid (2%) and Sorbitol (4%) solution for a total of 6 ml (2 ml per syringe), the remaining 30 patients did not receive any treatment. Inclusion criteria: age (ranging from 18 to 60 years), meniscectomy or cartilage treatment (non-bleeding knee arthroscopy), body mass index (<30). Patients with joint-line misalignment, ligamentous lesions, bone pathology, synovial membrane pathology, rheumatoid arthritis or inflammatory disease, or pregnancy were excluded from the study. Patients were reviewed at several follow-up points and monitored using outcomes such as the IKDC subjective knee evaluation score, pain variaton (using VAS and WOMAC pain sub-score) and variation of stiffness (using WOMAC Stiffnes sub-score). Patients were also asked to fill in a self-assessment questionnaire on a weekly basis as well as at each visit in order to follow the clinical evolution of the symptoms. The statistical analysis was performed with IBM SPSS Statistics for Windows, Version 28.0. Results: Patients injected with Synolis V-A at the short and intermediate check-points showing better clinical results than the patients that were not injected with the product; these patients had higher IKDC Subjective Knee Evaluation scores, as well as lower point of pain and reduced stiffness. Conclusions: Based on our results, the injection with hyaluronic acid (2%)/sorbitol (4%) formulation (Synolis V-A) in patients undergoing non-bleeding arthroscopy for degenerative and traumatic changes to the knee joint effectively reduces pain and improves mobility in the short-term post-operative phase.