title: Intra-articular injection of high molecular weight hyaluronan after arthrocentesis as treatment for rheumatoid knees with joint effusion.
abstract: OBJECTIVE
  The aim of this study was to find if a complete synovial fluid aspiration before injection of intra-articular high molecular weight hyaluronan influences the treatment result for knees with rheumatoid arthritis (RA), including joint effusion and the prognostic factors related to clinical effect.
  
  
  METHODS
  The arthritic knees including effusion were randomized to arthrocentesis or no arthrocentesis before the hyaluronan (1.9-2.5 x 10(6)) was injected into knee joints five times every week. All patients were followed up for 6 months.
  
  
  RESULTS
  One hundred eighteen RA patients (80 knees in the arthrocentesis group, 81 knees in the no-arthrocentesis group) were included. The proportion of no relapses in the arthrocentesis group was higher than that in the no-arthrocentesis group. In the arthrocentesis group, regression analysis showed that duration of knee arthritis (<5 months), CRP (<4 mg/dl), and Larsen grade (<grade II) were the significant predictors.
  
  
  CONCLUSIONS
  Arthrocentesis is effective in reducing the risk for arthritis relapse by intra-articular hyaluronan injection to rheumatoid knees with joint effusion. Predicting responders are duration of knee arthritis, CRP, and radiological scores.
authors.affiliation: Rheumatology Unit, Sapporo Gorinbashi Orthopedic Hospital in Gorinbashi Hospitals, 2-1, Kawazoe, Minami-ku, Sapporo, Hokkaido, 005-0802, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakahashi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sato
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hirose
authors.forename: Takumi
authors.initials: T
authors.lastname: Ishima
authors.forename: Seiichi
authors.initials: S
authors.lastname: Ishii
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D001182:Arthroscopy / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000187:drug effects / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D016017:Odds Ratio; D016059:Range of Motion, Articular / Q000502:physiology; D012016:Reference Values; D013582:Synovial Fluid / Q000378:metabolism; D013585:Synovitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid