Hyalonect in the treatment of pseudarthrosis

Acta Orthop Traumatol Turc. 2013;47(6):379-86. doi: 10.3944/aott.2013.2875.

Abstract

Objective: The aim of this study was to evaluate union rates and complications of Hyalonect, a knitted mesh composed of HYAFF, a benzyl ester of hyaluronic acid, and a naturally occurring constituent of the extracellular matrix, for the treatment of pseudarthrosis.

Methods: The study included 11 patients (8 male, 3 female; mean age: 44.6 years; range: 23 to 57 years) operated for pseudarthrosis using Hyalonect. Average time between initial treatment and surgical procedure was 12.9 (range: 8 to 48) months. Pseudarthrosis of the tibia, femur and humerus was present in 4, 2 and 5 patients, respectively. All patients had undergone prior surgery (1 to 6 times). Each patient underwent open reduction and internal fixation. Allograft was applied to the pseudarthrosis area and covered with Hyalonect. Mean follow up period was 31 (range: 12 to 48) months.

Results: Union was achieved in all patients after an average of 6 (range: 4 to 8) months. One patient had a discharge for two weeks. Another developed an infection which responded well to appropriate antibiotic treatment. No malunion or implant failure was observed. One patient with pre-existing radial nerve palsy maintained the condition.

Conclusion: Use of Hyalonect appears to be a safe method with a positive impact on union in the surgical treatment of pseudarthrosis, particularly in the absence of any infection.

MeSH terms

  • Adult
  • Allografts
  • Female
  • Femur / surgery
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods
  • Fracture Healing*
  • Humans
  • Humerus / surgery
  • Hyaluronic Acid / administration & dosage
  • Hyaluronic Acid / adverse effects
  • Hyaluronic Acid / analogs & derivatives*
  • Hyaluronic Acid / therapeutic use
  • Male
  • Middle Aged
  • Pseudarthrosis / surgery*
  • Radial Nerve / injuries
  • Range of Motion, Articular
  • Reoperation
  • Risk Factors
  • Surgical Mesh*
  • Tibia / surgery
  • Treatment Outcome
  • Viscosupplements / administration & dosage
  • Viscosupplements / adverse effects
  • Viscosupplements / therapeutic use*

Substances

  • Viscosupplements
  • hyaluronic acid benzyl ester
  • Hyaluronic Acid