The use of hylan G-F 20 after knee arthroscopy in an active patient population with knee osteoarthritis.
OBJECTIVE
The purpose of this study was to evaluate the efficacy of hylan G-F 20 when used to treat an active and athletic patient population with knee osteoarthritis who had undergone knee arthroscopy for mechanical symptoms.


METHODS
We performed a prospective evaluation of patients who underwent knee arthroscopy for mechanical symptoms. All patients had Outerbridge grade III or IV changes to their articular cartilage. If patients complained of residual pain or activity limitations postoperatively that was believed to be from osteoarthritis, they were treated with a series of hylan G-F 20 consisting of 3 weekly injections. International Knee Documentation Committee (IKDC) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores are reported for the time immediately before arthroscopy, at the time of the first hylan G-F 20 injection (baseline), at 3 months postoperatively, and at 6 months postoperatively. In addition, activity scores were calculated from a subset of the IKDC questionnaire before arthroscopy, at baseline, and at 3 months postoperatively.


RESULTS
Fifteen patients completed 6 months' follow-up. Baseline and 3- and 6-month IKDC and WOMAC scores were significantly improved compared with before arthroscopy. There was no significant difference in 3- and 6-month scores compared with baseline. The activity scores at baseline and at 3 months showed significant improvement compared with before arthroscopy. The activity scores also showed significant improvement at 3 months compared with baseline.


CONCLUSIONS
Hylan G-F 20 injections allow for improved activity levels at 3 months' follow-up. There was not a significant benefit of the injections when IKDC and WOMAC scores were evaluated. Hylan G-F 20 may be more beneficial for those patients who desire to increase their activity level rather than those who wish to decrease their pain.


METHODS
Level IV, therapeutic case series.
Zietz
Patrick M
PM
West Michigan Orthopaedics, Grand Rapids, Michigan, USA.
Selesnick
Harlan
H
D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001265:Athletic Injuries / Q000175:diagnosis / Q000628:therapy; D001672:Biocompatible Materials; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007270:Injections, Intra-Articular; D008297:Male; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000187:drug effects* / Q000502:physiology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D001672:Biocompatible Materials; C049816:hylan; D006820:Hyaluronic Acid