Update on viscosupplementation in the treatment of osteoarthritis of the foot and ankle.

In the recent past, nonsurgical treatment of osteoarthritis was limited to rest, immobilization, physical therapy, activity modifications, nonsteroidal anti-inflammatory drugs, analgesics, weight loss, assistive devices for walking, and corticosteroid injections. Viscosupplementation is a welcome addition to the nonsurgical armamentarium available to physicians. It is used to introduce hyaluronic acid into the joint to provide initial lubrication and shock absorption, and to change the long-term disease process.

Topical 5% 5-fluorouracil cream in the treatment of plantar warts: a prospective, randomized, and controlled clinical study.

Topical 5-fluorouracil (5-FU) is an antineoplastic antimetabolite that inhibits DNA and RNA synthesis, thereby preventing cell replication and proliferation. This mechanism of action may allow topical 5-FU to be utilized in the treatment of human papilloma virus (HPV). We conducted a study comparing 5% 5-FU cream under tape occlusion versus tape occlusion alone in 40 patients presenting with plantar warts.

Sodium hyaluronate in the treatment of osteoarthritis of the ankle: a controlled, randomized, double-blind pilot study.

Background: Intra-articular injections of hyaluronans have been shown to be safe and effective for the treatment of pain associated with osteoarthritis of the knee. This pilot study was undertaken to gather preliminary data on the efficacy and safety of five weekly intra-articular injections of Hyalgan (sodium hyaluronate; molecular weight, 500 to 730 kDa) as compared with saline solution for the treatment of pain associated with osteoarthritis of the ankle.

Methods: Twenty patients at two test sites were randomized with use of a double-blind (blinded observer), saline solution-controlled, parallel experimental design.

Viscosupplementation (hyaluronans) in the treatment of ankle osteoarthritis.

This pilot study was undertaken to gather preliminary data on the efficacy and safety of viscosupplementation with sodium hyaluronate versus phosphate-buffered saline control for pain associated with osteoarthritis (OA) of the ankle. Results suggest that five weekly intra-articular injections of sodium hyaluronate in patients who have OA of the ankle are well tolerated, can provide sustained relief of pain, and improve ankle function. These findings are consistent with previously published studies using intra-articular injections of sodium hyaluronate in other articular joints but require confirmation in a large, randomized, saline-controlled study.