title: Acute local reactions after intraarticular hylan for osteoarthritis of the knee.
abstract: OBJECTIVE
  To describe acute local reactions following intraarticular hylan injection and determine their frequency.
  
  
  METHODS
  Retrospective review of all patients with osteoarthritis of the knee treated with hylan by 3 rheumatologists.
  
  
  RESULTS
  Twenty-two patients had 88 injections to 28 knees. Six patients had reactions within 24 h of injection characterized by pain, warmth, and swelling, lasting up to 3 weeks. This occurrence was unpredictable. Corticosteroid injections were sometimes required. Synovial fluid cell counts were 5.0-75.0 x 10(9)/l, often with a prominent mononuclear component. Crystal studies and cultures were negative. Radiographic chondrocalcinosis was present in only 1 patient. One patient had serum antibodies to chicken serum proteins.
  
  
  CONCLUSIONS
  Intraarticular hylan was associated with significant local inflammatory reactions in 27% of patients, or 11% of injections. The mechanism(s) and long term sequelae are unclear.
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: M P
authors.initials: MP
authors.lastname: Puttick
authors.forename: J P
authors.initials: JP
authors.lastname: Wade
authors.forename: A
authors.initials: A
authors.lastname: Chalmers
authors.forename: D G
authors.initials: DG
authors.lastname: Connell
authors.forename: K K
authors.initials: KK
authors.lastname: Rangno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004487:Edema / Q000139:chemically induced; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D007249:Inflammation / Q000139:chemically induced; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D010146:Pain / Q000139:chemically induced; D012189:Retrospective Studies
chemical_list: C049816:hylan; D006820:Hyaluronic Acid