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Khaled F. M. Abdel-kader - One of the best experts on this subject based on the ideXlab platform.
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Prevention of post-traumatic osteoarthritis after intra-articular Knee Fractures using hyaluronic acid: a randomized prospective pilot study
International Orthopaedics, 2019Co-Authors: Ahmed Samir Barakat, Nour Muhamad Ibrahim, Osama Hassan Elghobashy, Ahmed Maher Sultan, Khaled F. M. Abdel-kaderAbstract:Purpose Based on the irreversible destruction of hyaline cartilage, post-traumatic osteoarthritis (PTOA) is a notorious sequelae after intra-articular Knee Fractures. This study evaluates the clinical efficacy and applicability of immediate post-operative intra-articular injection of hyaluronic acid (IA HA) into the Knee joint with an intra-articular Fracture. Methods Prospective randomized case-control study involving 40 patients (20 in each group) with intra-articular Knee Fracture with an average follow-up of 23 months (range 18–24 months). Twenty patients with intra-articular distal femoral or intra-articular proximal tibial Fractures who met our inclusion criteria received three intra-articular hyaluronic acid injections weekly starting immediately after ORIF. Another 20 patients serving as a control group received no injection after ORIF. Patients were assessed functionally with Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) score. Plain X-rays and when indicated CT scans were used to assess radiological union. Results The results showed patients treated with intra-articular hyaluronic acid injection after fixation had significantly less pain (KOOS) ( p = 0.01). No significant difference was found between both groups in other KOOS-related outcome measures, complications, functional outcome, or quality of life. Conclusions These preliminary results support a direct role for hyaluronic acid in the acute phase of the inflammatory process that follows articular injury and provides initial evidence for the efficacy of IA HA.
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Prevention of post-traumatic osteoarthritis after intra-articular Knee Fractures using hyaluronic acid: a randomized prospective pilot study.
International orthopaedics, 2019Co-Authors: Ahmed Samir Barakat, Nour Muhamad Ibrahim, Osama Hassan Elghobashy, Ahmed Maher Sultan, Khaled F. M. Abdel-kaderAbstract:Based on the irreversible destruction of hyaline cartilage, post-traumatic osteoarthritis (PTOA) is a notorious sequelae after intra-articular Knee Fractures. This study evaluates the clinical efficacy and applicability of immediate post-operative intra-articular injection of hyaluronic acid (IA HA) into the Knee joint with an intra-articular Fracture. Prospective randomized case-control study involving 40 patients (20 in each group) with intra-articular Knee Fracture with an average follow-up of 23 months (range 18–24 months). Twenty patients with intra-articular distal femoral or intra-articular proximal tibial Fractures who met our inclusion criteria received three intra-articular hyaluronic acid injections weekly starting immediately after ORIF. Another 20 patients serving as a control group received no injection after ORIF. Patients were assessed functionally with Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) score. Plain X-rays and when indicated CT scans were used to assess radiological union. The results showed patients treated with intra-articular hyaluronic acid injection after fixation had significantly less pain (KOOS) (p = 0.01). No significant difference was found between both groups in other KOOS-related outcome measures, complications, functional outcome, or quality of life. These preliminary results support a direct role for hyaluronic acid in the acute phase of the inflammatory process that follows articular injury and provides initial evidence for the efficacy of IA HA.
Veronique Vestergaard - One of the best experts on this subject based on the ideXlab platform.
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Patient-reported outcomes of 7133 distal femoral, patellar, and proximal tibial Fracture patients: A national cross-sectional study with one-, three-, and five-year follow-up.
The Knee, 2020Co-Authors: Veronique Vestergaard, Kristoffer Borbjerg Hare, Anders Troelsen, Henrik Morville Schrøder, Peter Toquer, Alma B PedersenAbstract:Abstract Background Few studies have described patient-reported outcome measures (PROMs) in Knee Fracture patients. We reported Knee-specific and generic median PROM scores after Knee Fracture and identified risk factors for poor outcome defined by low median PROM scores. Methods In a Danish cross-sectional study of 7133 distal femoral, patellar, and proximal tibial Fracture patients during 2011–2017, OKS, FJS-12, EQ5D-5L Index, and EQ5D-5L Visual Analogue Scale (VAS), were collected electronically (response rate 53%; median age 60; 63% female). Poor outcome was defined as score lower than median PROM score. Poor outcome risk factors were estimated as odds ratios from binary logistic regression models. Results At 0 to one year after Knee Fracture, median PROM scores were 31 (OKS), 27 (FJS-12), 0.50 (EQ5D-5L Index), and 74 (EQ5D-5L VAS). At > 5 years after Knee Fracture, median OKS score was 40, median FJS-12 score was 54, median EQ5D-5L Index was 0.76, and median EQ5D-5L VAS score was 80. Age > 40 years had higher odds for poor OKS and FJS-12 scores at short- and long-term follow-up after Knee Fracture. Comorbidity burden, distal femoral Fracture, and treatment with external fixation and Knee arthroplasty were risk factors for poor outcome at long-term follow-up, for all four PROMs. Conclusions Although Knee Fracture patients have relatively high Knee function and quality of life, their ability to forget about the Knee joint after Knee Fracture is compromised. We identified several important risk factors for poor outcome measured by PROMs at different follow-up periods following Knee Fracture, which will help direct future quality-improvement initiatives.
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Knee Fracture Increases TKA Risk After Initial Fracture Treatment and Throughout Life.
Clinical orthopaedics and related research, 2019Co-Authors: Veronique Vestergaard, Alma B Pedersen, Kristoffer Borbjerg Hare, Henrik M Schrøder, Anders TroelsenAbstract:BACKGROUND Knee Fractures may lead to post-traumatic Knee osteoarthritis and subsequent TKA in some patients. However, absolute risk estimates and risk factors for TKA in patients with Knee Fractures compared with those of the general population remain largely unknown. Such knowledge would help establish the treatment burden and direct patient counseling after a Knee Fracture is sustained. QUESTIONS/PURPOSES (1) What is the short-term risk of TKA after Knee Fracture? (2) What is the long-term risk of TKA after Knee Fracture? (3) What are the risk factors for TKA in patients with Knee Fractures? METHODS A nationwide 20-year, matched-case comparison cohort study of prospectively collected data from the Danish National Patient Registry included all patients at least 15 years old with International Classification of Diseases, 10th revision codes DS724, DS820, or DS821 (Knee Fractures) on the date their Knee Fracture was registered. Each patient with a Knee Fracture was matched (by sex and age) to five people without Knee Fractures from the general Danish population on the date the Knee Fracture patient's Knee Fracture was registered (population controls). Patients with Knee Fractures and people in the population control group were followed from the date the Knee Fracture patient's Knee Fracture was registered to the date of TKA, amputation, Knee fusion, emigration, death, or end of follow-up in April 2018. TKA risks for patients with Knee Fractures versus those for population controls and TKA risk factors in patients with Knee Fractures were estimated using hazard ratios (HRs) with 95% CIs. A total of 48,791 patients with Knee Fractures (median age 58 years [interquartile range 41-73]; 58% were female) were matched to 263,593 people in the population control group. RESULTS The HR for TKA in patients with Knee Fractures compared with population controls was 3.74 (95% CI 3.44 to 4.07; p < 0.01) in the first 3 years after Knee Fracture. Among Knee Fracture patients, the risk of undergoing TKA was 2% (967 of 48,791) compared with 0.5% (1280 of 263,593) of people in the population control group. After the first 3 years, the HR was 1.59 (95% CI 1.46 to 1.71) and the number of patients with Knee Fractures with TKA events divided by the number at risk was 2% (849 of 36,272), compared with 1% (2395 of 180,418) of population controls. During the 20-year study period, 4% of patients with Knee Fractures underwent TKA compared with 1% of population controls. Risk factors for TKA in patients with Knee Fractures were: primary Knee osteoarthritis (OA) versus no primary Knee OA (HR 9.57 [95% CI 5.39 to 16.98]), surgical treatment with external fixation versus open reduction and internal fixation and reduction only (HR 1.92 [95 % CI 1.01 to 3.66]), proximal tibia Fracture versus patellar Fracture (HR 1.75 [95 % CI 1.30 to 2.36]), and distal femur Fracture versus patellar Fracture (HR 1.68 [95 % CI 1.08 to 2.64]). Surgical treatment of Knee Fractures was also a risk factor for TKA. The HRs for TKA in patients with Knee Fractures who were surgically treated versus those who were treated non-surgically were 2.05 (95% CI 1.83 to 2.30) in the first 5 years after Knee Fracture and 1.19 (95% CI 1.01 to 1.41) after 5 years. CONCLUSIONS Patients with Knee Fractures have a 3.7 times greater risk of TKA in the first 3 years after Knee Fracture, and the risk remains 1.6 times greater after 3 years and throughout their lifetimes. Primary Knee OA, surgical treatment of Knee Fractures, external fixation, proximal tibia Fractures, and distal femur Fractures are TKA risk factors. These risk estimates and risk factors highlight the treatment burden of Knee Fractures, building a foundation for future studies to further counsel patients on their risk of undergoing TKA based on patient-, Fracture-, and treatment-specific factors. LEVEL OF EVIDENCE Level III, prognostic study.
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20-year trends of distal femoral, patellar, and proximal tibial Fractures: a Danish nationwide cohort study of 60,823 patients.
Acta orthopaedica, 2019Co-Authors: Veronique Vestergaard, Alma B Pedersen, Anders Troelsen, Peter Toft Tengberg, Henrik M SchrøderAbstract:Background and purpose - Knee Fracture treatment burden remains unknown, impeding proper use of hospital resources. We examined 20-year trends in incidence rates (IRs) and patient-, Fracture-, and treatment-related characteristics of Knee Fracture patients.Patients and methods - This nationwide cohort study of prospectively collected data including patients with distal femoral, patellar, and proximal tibial Fractures from the Danish National Patient Registry during 1998-2017, assesses IRs of Knee Fractures (per 105 inhabitants) as well as patient-, Fracture-, and treatment-related characteristics of Knee Fracture patients.Results - During 1998-2017, 60,823 patients (median age 55; 57% female) sustained 74,106 Knee Fractures. 74% of the study population had a Charlson Comorbidity Index (CCI) of 0 and 18% a CCI of ≥ 2. 51% were proximal tibial Fractures, 31% patellar Fractures, and 18% distal femoral Fractures. At the time of Knee Fracture, 20% patients had concomitant near-Knee Fractures (femur/tibia/fibula shaft/hip/ankle), 13% concomitant Fractures (pelvic/spine/thorax/upper extremities), 5% osteoporosis, and 4% primary Knee osteoarthritis. Over 1/3 Knee Fractures were surgically treated and of these 86% were open-reduction internal fixations, 9% external fixations, and 5% Knee arthroplasties. The most common surgery type was proximal tibia plating (n = 4,868; 60% female). Knee Fracture IR increased 12% to 70, females aged > 51 had the highest Knee Fracture IR, proximal tibial Fracture had the highest Knee Fracture type IR (32) and surgically treated Knee Fracture IR increased 35% to 23.Interpretation - Knee Fracture IRs, especially of surgically treated Knee Fractures, are increasing and proximal tibial Fracture has the highest Knee Fracture type IR. Females aged > 51 and patients with comorbidity are associated with Knee Fracture, proximal tibial Fracture, proximal tibial Fracture surgery, and posttraumatic Knee arthroplasty.
Henrik M Schrøder - One of the best experts on this subject based on the ideXlab platform.
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Knee Fracture Increases TKA Risk After Initial Fracture Treatment and Throughout Life.
Clinical orthopaedics and related research, 2019Co-Authors: Veronique Vestergaard, Alma B Pedersen, Kristoffer Borbjerg Hare, Henrik M Schrøder, Anders TroelsenAbstract:BACKGROUND Knee Fractures may lead to post-traumatic Knee osteoarthritis and subsequent TKA in some patients. However, absolute risk estimates and risk factors for TKA in patients with Knee Fractures compared with those of the general population remain largely unknown. Such knowledge would help establish the treatment burden and direct patient counseling after a Knee Fracture is sustained. QUESTIONS/PURPOSES (1) What is the short-term risk of TKA after Knee Fracture? (2) What is the long-term risk of TKA after Knee Fracture? (3) What are the risk factors for TKA in patients with Knee Fractures? METHODS A nationwide 20-year, matched-case comparison cohort study of prospectively collected data from the Danish National Patient Registry included all patients at least 15 years old with International Classification of Diseases, 10th revision codes DS724, DS820, or DS821 (Knee Fractures) on the date their Knee Fracture was registered. Each patient with a Knee Fracture was matched (by sex and age) to five people without Knee Fractures from the general Danish population on the date the Knee Fracture patient's Knee Fracture was registered (population controls). Patients with Knee Fractures and people in the population control group were followed from the date the Knee Fracture patient's Knee Fracture was registered to the date of TKA, amputation, Knee fusion, emigration, death, or end of follow-up in April 2018. TKA risks for patients with Knee Fractures versus those for population controls and TKA risk factors in patients with Knee Fractures were estimated using hazard ratios (HRs) with 95% CIs. A total of 48,791 patients with Knee Fractures (median age 58 years [interquartile range 41-73]; 58% were female) were matched to 263,593 people in the population control group. RESULTS The HR for TKA in patients with Knee Fractures compared with population controls was 3.74 (95% CI 3.44 to 4.07; p < 0.01) in the first 3 years after Knee Fracture. Among Knee Fracture patients, the risk of undergoing TKA was 2% (967 of 48,791) compared with 0.5% (1280 of 263,593) of people in the population control group. After the first 3 years, the HR was 1.59 (95% CI 1.46 to 1.71) and the number of patients with Knee Fractures with TKA events divided by the number at risk was 2% (849 of 36,272), compared with 1% (2395 of 180,418) of population controls. During the 20-year study period, 4% of patients with Knee Fractures underwent TKA compared with 1% of population controls. Risk factors for TKA in patients with Knee Fractures were: primary Knee osteoarthritis (OA) versus no primary Knee OA (HR 9.57 [95% CI 5.39 to 16.98]), surgical treatment with external fixation versus open reduction and internal fixation and reduction only (HR 1.92 [95 % CI 1.01 to 3.66]), proximal tibia Fracture versus patellar Fracture (HR 1.75 [95 % CI 1.30 to 2.36]), and distal femur Fracture versus patellar Fracture (HR 1.68 [95 % CI 1.08 to 2.64]). Surgical treatment of Knee Fractures was also a risk factor for TKA. The HRs for TKA in patients with Knee Fractures who were surgically treated versus those who were treated non-surgically were 2.05 (95% CI 1.83 to 2.30) in the first 5 years after Knee Fracture and 1.19 (95% CI 1.01 to 1.41) after 5 years. CONCLUSIONS Patients with Knee Fractures have a 3.7 times greater risk of TKA in the first 3 years after Knee Fracture, and the risk remains 1.6 times greater after 3 years and throughout their lifetimes. Primary Knee OA, surgical treatment of Knee Fractures, external fixation, proximal tibia Fractures, and distal femur Fractures are TKA risk factors. These risk estimates and risk factors highlight the treatment burden of Knee Fractures, building a foundation for future studies to further counsel patients on their risk of undergoing TKA based on patient-, Fracture-, and treatment-specific factors. LEVEL OF EVIDENCE Level III, prognostic study.
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20-year trends of distal femoral, patellar, and proximal tibial Fractures: a Danish nationwide cohort study of 60,823 patients.
Acta orthopaedica, 2019Co-Authors: Veronique Vestergaard, Alma B Pedersen, Anders Troelsen, Peter Toft Tengberg, Henrik M SchrøderAbstract:Background and purpose - Knee Fracture treatment burden remains unknown, impeding proper use of hospital resources. We examined 20-year trends in incidence rates (IRs) and patient-, Fracture-, and treatment-related characteristics of Knee Fracture patients.Patients and methods - This nationwide cohort study of prospectively collected data including patients with distal femoral, patellar, and proximal tibial Fractures from the Danish National Patient Registry during 1998-2017, assesses IRs of Knee Fractures (per 105 inhabitants) as well as patient-, Fracture-, and treatment-related characteristics of Knee Fracture patients.Results - During 1998-2017, 60,823 patients (median age 55; 57% female) sustained 74,106 Knee Fractures. 74% of the study population had a Charlson Comorbidity Index (CCI) of 0 and 18% a CCI of ≥ 2. 51% were proximal tibial Fractures, 31% patellar Fractures, and 18% distal femoral Fractures. At the time of Knee Fracture, 20% patients had concomitant near-Knee Fractures (femur/tibia/fibula shaft/hip/ankle), 13% concomitant Fractures (pelvic/spine/thorax/upper extremities), 5% osteoporosis, and 4% primary Knee osteoarthritis. Over 1/3 Knee Fractures were surgically treated and of these 86% were open-reduction internal fixations, 9% external fixations, and 5% Knee arthroplasties. The most common surgery type was proximal tibia plating (n = 4,868; 60% female). Knee Fracture IR increased 12% to 70, females aged > 51 had the highest Knee Fracture IR, proximal tibial Fracture had the highest Knee Fracture type IR (32) and surgically treated Knee Fracture IR increased 35% to 23.Interpretation - Knee Fracture IRs, especially of surgically treated Knee Fractures, are increasing and proximal tibial Fracture has the highest Knee Fracture type IR. Females aged > 51 and patients with comorbidity are associated with Knee Fracture, proximal tibial Fracture, proximal tibial Fracture surgery, and posttraumatic Knee arthroplasty.
Peter V. Giannoudis - One of the best experts on this subject based on the ideXlab platform.
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Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures: A Systematic Review and Meta-analysis.
JAMA network open, 2019Co-Authors: Grayson R. Norris, Jake X. Checketts, Jared Scott, Matt Vassar, Brent Norris, Peter V. GiannoudisAbstract:Importance Surgical management of periarticular Knee Fractures can be challenging, and adverse outcomes may be severe. Recent literature indicates that the rate of periarticular Knee surgical site infection (SSI) may range from 2% to 88% depending on the Fracture site. Objective To examine the prevalence of deep SSI and the rate of septic arthritis after surgical repair of Fractures around the Knee. Data Sources The electronic databases MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception to July 1, 2018. Study Selection Eligible studies had to specifically report deep SSI rates and include Fractures in the distal femur, patella, tibial plateau, or proximal tibia. Risk factors that were associated with increased the risk of deep SSI were also examined. Data Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data were extracted by multiple investigators. Comprehensive Meta-Analysis software was used for the pooling of data, using either random-effects or fixed-effects models, with respect to the degree of statistical heterogeneity present. Data analyses were conducted in October 2018. Main Outcomes and Measures The primary outcome was overall prevalence of deep SSI after periarticular Knee Fracture repair. The secondary outcomes were the overall prevalence of septic arthritis, risk factors associated with deep SSI, and the most commonly cultured bacteria specimens found periarticular Knee infections. Results Of 6928 articles screened, 117 articles met inclusion criteria and were included in analysis. Among 11 432 patients included in analysis, 653 patients (5.7%) experienced deep SSIs, most commonly among patients with proximal tibia Fractures (56 of 872 patients [6.4%]). Among studies that included information on septic arthritis, 38 of 1567 patients (2.4%) experienced septic arthritis. The 2 most commonly reported bacteria were methicillin-resistantStaphylococcus aureus, found in 67 SSIs, and methicillin-susceptibleS aureus, found in 53 SSIs. Sixty-two studies (53.0%) in the sample received a Coleman Methodological Score of poor ( Conclusions and Relevance Deep SSIs occurred in nearly 6% of periarticular Knee Fracture repairs, and 2.4% of SSIs were associated with septic arthritis. Surgeons managing these injuries should be vigilant when wounds are not pristine. Efforts should be made to elevate the quality of research conducted not only in this subject but also in orthopedic surgery as a whole.
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Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures: A systematic review and meta-analysis
'American Medical Association (AMA)', 2019Co-Authors: Gr Norris, Jake X. Checketts, Jt Scott, Vassar M, Bl Norris, Peter V. GiannoudisAbstract:Importance Surgical management of periarticular Knee Fractures can be challenging, and adverse outcomes may be severe. Recent literature indicates that the rate of periarticular Knee surgical site infection (SSI) may range from 2% to 88% depending on the Fracture site. Objective To examine the prevalence of deep SSI and the rate of septic arthritis after surgical repair of Fractures around the Knee. Data Sources The electronic databases MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception to July 1, 2018. Study Selection Eligible studies had to specifically report deep SSI rates and include Fractures in the distal femur, patella, tibial plateau, or proximal tibia. Risk factors that were associated with increased the risk of deep SSI were also examined. Data Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data were extracted by multiple investigators. Comprehensive Meta-Analysis software was used for the pooling of data, using either random-effects or fixed-effects models, with respect to the degree of statistical heterogeneity present. Data analyses were conducted in October 2018. Main Outcomes and Measures The primary outcome was overall prevalence of deep SSI after periarticular Knee Fracture repair. The secondary outcomes were the overall prevalence of septic arthritis, risk factors associated with deep SSI, and the most commonly cultured bacteria specimens found periarticular Knee infections. Results Of 6928 articles screened, 117 articles met inclusion criteria and were included in analysis. Among 11 432 patients included in analysis, 653 patients (5.7%) experienced deep SSIs, most commonly among patients with proximal tibia Fractures (56 of 872 patients [6.4%]). Among studies that included information on septic arthritis, 38 of 1567 patients (2.4%) experienced septic arthritis. The 2 most commonly reported bacteria were methicillin-resistant Staphylococcus aureus, found in 67 SSIs, and methicillin-susceptible S aureus, found in 53 SSIs. Sixty-two studies (53.0%) in the sample received a Coleman Methodological Score of poor (
Ahmed Samir Barakat - One of the best experts on this subject based on the ideXlab platform.
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Prevention of post-traumatic osteoarthritis after intra-articular Knee Fractures using hyaluronic acid: a randomized prospective pilot study
International Orthopaedics, 2019Co-Authors: Ahmed Samir Barakat, Nour Muhamad Ibrahim, Osama Hassan Elghobashy, Ahmed Maher Sultan, Khaled F. M. Abdel-kaderAbstract:Purpose Based on the irreversible destruction of hyaline cartilage, post-traumatic osteoarthritis (PTOA) is a notorious sequelae after intra-articular Knee Fractures. This study evaluates the clinical efficacy and applicability of immediate post-operative intra-articular injection of hyaluronic acid (IA HA) into the Knee joint with an intra-articular Fracture. Methods Prospective randomized case-control study involving 40 patients (20 in each group) with intra-articular Knee Fracture with an average follow-up of 23 months (range 18–24 months). Twenty patients with intra-articular distal femoral or intra-articular proximal tibial Fractures who met our inclusion criteria received three intra-articular hyaluronic acid injections weekly starting immediately after ORIF. Another 20 patients serving as a control group received no injection after ORIF. Patients were assessed functionally with Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) score. Plain X-rays and when indicated CT scans were used to assess radiological union. Results The results showed patients treated with intra-articular hyaluronic acid injection after fixation had significantly less pain (KOOS) ( p = 0.01). No significant difference was found between both groups in other KOOS-related outcome measures, complications, functional outcome, or quality of life. Conclusions These preliminary results support a direct role for hyaluronic acid in the acute phase of the inflammatory process that follows articular injury and provides initial evidence for the efficacy of IA HA.
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Prevention of post-traumatic osteoarthritis after intra-articular Knee Fractures using hyaluronic acid: a randomized prospective pilot study.
International orthopaedics, 2019Co-Authors: Ahmed Samir Barakat, Nour Muhamad Ibrahim, Osama Hassan Elghobashy, Ahmed Maher Sultan, Khaled F. M. Abdel-kaderAbstract:Based on the irreversible destruction of hyaline cartilage, post-traumatic osteoarthritis (PTOA) is a notorious sequelae after intra-articular Knee Fractures. This study evaluates the clinical efficacy and applicability of immediate post-operative intra-articular injection of hyaluronic acid (IA HA) into the Knee joint with an intra-articular Fracture. Prospective randomized case-control study involving 40 patients (20 in each group) with intra-articular Knee Fracture with an average follow-up of 23 months (range 18–24 months). Twenty patients with intra-articular distal femoral or intra-articular proximal tibial Fractures who met our inclusion criteria received three intra-articular hyaluronic acid injections weekly starting immediately after ORIF. Another 20 patients serving as a control group received no injection after ORIF. Patients were assessed functionally with Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) score. Plain X-rays and when indicated CT scans were used to assess radiological union. The results showed patients treated with intra-articular hyaluronic acid injection after fixation had significantly less pain (KOOS) (p = 0.01). No significant difference was found between both groups in other KOOS-related outcome measures, complications, functional outcome, or quality of life. These preliminary results support a direct role for hyaluronic acid in the acute phase of the inflammatory process that follows articular injury and provides initial evidence for the efficacy of IA HA.