Effects of intra-articular hylan G-F 20 injections on clinical and biomechanical characteristics of the knee in osteoarthritis.
The objectives of this study were to investigate the effects of Hylan G-F 20 (Synvisc; Genzyme Biosurgery, Ridgefield, New Jersey, USA) injections on clinical and biomechanical gait characteristics of patients with knee osteoarthritis. The design was a before-after trial, set in the gait laboratory of the rehabilitation unit of a university hospital. Twelve patients participated with an average age (+/-SD) of 63.2+/-4.4 years, and Kellgren and Lawrence grade II or III knee osteoarthritis. The main outcome measures were the Western Ontario McMaster Universities Osteoarthritis Index, and time-distance, kinematic and kinetic parameters of gait. The intervention used was a single course of three bilateral intra-articular injections of 2 ml Hylan G-F 20. One week after the treatment, the pain subscore and total score of WOMAC decreased from 9.2+/-2.7 to 4.8+/-3.1 and from 42.1+/-15.2 to 37.9+/-13.5, respectively. There was improvement in sagittal plane excursions of the knee (from 40.2+/-8.1 to 43.3+/-8.5), in extensor and adductor moments (from 0.26+/-0.2 to 0.14+/-0.1 and from 0.45+/-0.1 to 0.41+/-0.1, respectively), and in scaled vertical forces (from 85.8+/-4.5 to 88.4+/-5.4). All these differences were statistically significant. In conclusion, intra-articular Hylan G-F 20 injections not only decrease pain in patients with knee osteoarthritis, but can alter the natural history of the disease by decreasing excessive loads in the knees.
Yavuzer
Güneş
G
Ankara University Medical School, Department of Physical Medicine and Rehabilitation, Ankara, Turkey. gunesyavuzer@hotmail.com
Sonel
Birkan
B
Süldür
Nurben
N
Ergin
Süreyya
S
D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000187:drug effects*; D006304:Health Status; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D016896:Treatment Outcome
C049816:hylan; D006820:Hyaluronic Acid