Management of knee osteoarthritis: knee lavage combined with hylan versus hylan alone.
OBJECTIVE
To assess the difference in efficacy between knee lavage plus the standard hylan G-F 20 (a derivative of hyaluronan) protocol and the standard hylan G-F 20 as per standard usage protocol alone for the treatment of knee osteoarthritis (OA).


METHODS
Nonrandomized prospective study in which patients chose their treatment group. Follow-up averaged 1.1 years.


METHODS
Faculty practice of a single physician at a major teaching hospital.


METHODS
Eighty-one patients with documented knee OA on magnetic resonance imaging.


METHODS
Group 1 (n=44) received a single-needle lavage 1 week before the standard hylan G-F 20 protocol; group 2 (n=37) received the standard hylan G-F 20 protocol alone.


METHODS
Pre- and posttreatment scores on the Lysholm-II Questionnaire and a visual analog scale (VAS) were documented for each patient. The Wilcoxon signed-rank test was used for statistical analysis.


RESULTS
A successful outcome was noted in 79.5% of group 1 patients and in 54% of group 2 patients (P<.05).


CONCLUSIONS
In the management of knee OA, the use of knee lavage before viscosupplementation with hylan G-F 20 yields better results than using hylan G-F 20 alone. The presence of radiologic grade IV knee OA or moderate to severe patellofemoral arthritis are negative prognostic factors.
Vad
Vijay B
VB
Hospital for Special Surgery, New York, NY 10021, USA. vadv@hss.edu
Bhat
Atul L
AL
Sculco
Thomas P
TP
Wickiewicz
Thomas L
TL
D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000737:chemistry / Q000494:pharmacology; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010147:Pain Measurement; D017060:Patient Satisfaction; D018579:Patient Selection; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome
C049816:hylan; D006820:Hyaluronic Acid