What is the role of Monovisc (high molecular weight hyaluronan) after Anterior Cruciate Ligament (ACL) tear?

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From the Guidelines

Monovisc may be considered for pain management after an ACL tear, but it's not a primary treatment. Monovisc is a single-injection hyaluronic acid viscosupplement typically used for osteoarthritis pain relief, not specifically for ACL injuries. The standard treatment for an ACL tear includes rest, ice, compression, elevation (RICE protocol), physical therapy, and possibly surgical reconstruction depending on the severity of the tear and your activity level. If you have developed secondary osteoarthritis following an ACL tear, Monovisc might be prescribed to reduce pain and improve joint function. The typical dose is one 4ml injection into the affected knee joint, administered by an orthopedic specialist or sports medicine physician. The injection provides lubrication and shock absorption properties that can last up to six months. However, it's essential to understand that Monovisc treats symptoms only and doesn't repair the ACL tear itself. You should discuss with your doctor whether this treatment is appropriate for your specific condition, as its effectiveness varies among patients and it works best when combined with a comprehensive rehabilitation program 1.

Some key points to consider:

  • The primary treatment for an ACL tear is rest, ice, compression, elevation, physical therapy, and possibly surgical reconstruction 1.
  • Monovisc is typically used for osteoarthritis pain relief, not specifically for ACL injuries 1.
  • The injection provides lubrication and shock absorption properties that can last up to six months 1.
  • Monovisc treats symptoms only and doesn't repair the ACL tear itself 1.
  • The effectiveness of Monovisc varies among patients and it works best when combined with a comprehensive rehabilitation program 1.

It's crucial to follow the recommended treatment guidelines and discuss any concerns or questions with your doctor to ensure the best possible outcome for your specific condition.

From the Research

Monovisc after ACL Tear

  • Monovisc, a type of hyaluronic acid, has been studied as a potential treatment for ACL tears to reduce inflammatory stress and improve articular function 2.
  • A randomized controlled trial found that a single injection of hyaluronic acid after ACL reconstruction improved active range of motion and reduced transpatellar circumference, but did not lead to significant improvement in clinical scores 2.
  • Another study found that arthroscopic anterior cruciate ligament reconstruction combined with sodium hyaluronate improved knee function and reduced inflammatory markers in ACL injury patients with or without knee osteoarthritis 3.

Treatment Options for ACL Tears

  • The optimal treatment for an ACL tear depends on patient-specific factors, including age, occupation, and desired activity level 4.
  • Nonoperative management, consisting of physical therapy, bracing, and activity modification, can be effective for less active patients with sedentary jobs 4.
  • ACL reconstruction is recommended for active patients who want to resume participation in jumping, cutting, or pivoting sports, or for patients who have physically demanding occupations 4.

Rehabilitation and Recovery

  • Rehabilitation is an essential part of treatment for ACL tears, and evidence-based rehabilitation recommendations include phase-specific exercises and criteria to inform return to sport decisions 5.
  • A systematic review found that nonoperative treatment with a well-designed rehabilitative program can be an effective option for isolated ACL tears, and may even reduce the risk of developing radiological signs of osteoarthritis 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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