Treatment of Avascular Necrosis with Hyaluronic Acid in the Cancer Population: A Case Series

Background: Intra-articular hyaluronic acid (HA) injections in non-cancer patient populations have shown some positive outcomes in treating avascular necrosis, however outcomes in the oncology population are scarce. This pilot study describes 7 oncology patients who received ultrasound-guided HA injections and their associated outcomes. Case Report: This study included 4 female and 3 male patients with radiographic evidence of avascular necrosis. Six of the patients had avascular necrosis of the hip, while one patient had avascular necrosis of the shoulder. All patients underwent single or multiple ultrasound-guided injection(s) of hyaluronic acid to the affected joint. Outcomes were tracked using a combination of subjective pain and functional improvement and/or numeric pain scale. Five patients had improvement in their symptoms, while 2 patients did not. Conclusion: Intra-articular HA may be a viable alternative to the treatment of avascular necrosis in oncology patients. Key words: Avascular necrosis, cancer pain, case series, hyaluronic acid, joint pain