title: Does joint effusion influence the clinical response to a single Hylan GF-20 injection for hip osteoarthritis?
abstract: OBJECTIVE
  To evaluate the influence of a joint effusion on the clinical response to a single injection of Hylan GF-20 for hip osteoarthritis.
  
  
  METHODS
  We prospectively included patients scheduled for intraarticular Hylan GF-20 injection to treat hip osteoarthritis. Disease severity was assessed based on the Kellgren-Lawrence radiological grade. Ultrasonography was performed to look for a joint effusion. The pain score on a visual analog scale, Lequesne algofunctional index, and WOMAC scores were recorded at baseline and 1, 3, and 6 months postinjection. The proportions of patients who met OARSI response criteria and who achieved Patient Acceptable Symptom State (PASS) thresholds were determined in the overall population and in the groups with and without a joint effusion at baseline.
  
  
  RESULTS
  Of 55 included patients, 24 (44%) had an effusion at baseline. The baseline Lequesne index was significantly higher in the group with an effusion (11.9+/-3.6 versus 8.4+/-4.5) (p=0.003). The proportions of OARSI responders in the overall population were 31.8%, 39.4%, and 14.8% after 1, 3, and 6 months, respectively. The proportions of patients who achieved the PASS for pain and function were 52.4% and 50.0% after 1 month, 67.7% and 54.5% after 3 months, and 60.0% and 50.0% after 6 months, respectively. Presence of an effusion at baseline had no effect on any of the clinical response parameters.
  
  
  CONCLUSIONS
  Presence of a joint effusion is associated with worse pain and functional impairment at baseline but has no influence on the clinical response to Hylan GF-20 in patients with hip osteoarthritis.
authors.affiliation: Rheumatology Department, Nancy Teaching Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Rennesson-Rey
authors.forename: Anne-Christine
authors.initials: AC
authors.lastname: Rat
authors.forename: Isabelle
authors.initials: I
authors.lastname: Chary-Valckenaere
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bettembourg-Brault
authors.forename: Nadine
authors.initials: N
authors.lastname: Juge
authors.forename: Hervé
authors.initials: H
authors.lastname: Dintinger
authors.forename: Jacques
authors.initials: J
authors.lastname: Pourel
authors.forename: Damien
authors.initials: D
authors.lastname: Loeuille
mesh_terms: D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000188:drug therapy*; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index; D013582:Synovial Fluid / Q000000981:diagnostic imaging / Q000502:physiology*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D001672:Biocompatible Materials; C049816:hylan; D006820:Hyaluronic Acid