Long-term experience with hylan GF-20 in the treatment of knee osteoarthritis.
BACKGROUND
Osteoarthritis is the most frequent musculoskeletal disease and a major cause of disability in the elderly. Knee osteoarthritis is the first cause of consultations for osteoarthritis-related symptoms. Its current management requires the combination of pharmaceutical and non-pharmacological strategies, including intra-articular injections of hyaluronic acid that are aimed at decreasing pain and improving joint function by restoring joint homeostasis (viscosupplementation). Hylan GF-20 is a cross-linked hyaluronic acid derivative, FDA approved as a medical device since 1997 for the treatment of patients with symptomatic knee osteoarthritis.


OBJECTIVE
This review aims to summarise recently published evidence and offer practical suggestions to clinical colleagues who are considering including viscosupplementation in their practices.


METHODS
The authors reviewed extensively the published papers on the topic, but selected only those that appeared to be the most relevant, on the mechanisms of action, efficacy and safety of the treatment, clinical predictors of response, ideal dosing regimen and differences between commercial preparations. They also give their own clinical experience with hylan GF-20 as a symptomatic treatment of knee osteoarthritis.


CONCLUSIONS
Data of the literature clearly demonstrate that hylan GF-20 is a safe and effective treatment for decreasing pain and improving function in patients suffering from knee osteoarthritis. Its long-term (10 years) use allows knowing with accuracy the main indications, contraindications, side effects and prognostic factors of response, which are all extensively discussed throughout this review.
Service de rhumatologie, Centre hospitalier Lyon-Sud, 165 chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France. thierry.conrozier@chu-lyon.fr
Thierry
T
Conrozier
Xavier
X
Chevalier
D002986:Clinical Trials as Topic; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D015201:Meta-Analysis as Topic; D020370:Osteoarthritis, Knee / Q000188:drug therapy*
C049816:hylan; D006820:Hyaluronic Acid