title: Rate of adverse reactions to more than 1 series of viscosupplementation.
abstract: Viscosupplementation, hyaluronic acid treatment, is an ancillary method for treating patients with symptomatic stage I or II osteoarthritis. Previous studies reported that local reactions occurred more frequently in patients receiving >1 course of treatment compared with patients receiving their first course of treatment. One (2%) of 42 first series patients and 4 (21%) of 19 of repeated series patients had adverse reactions severe enough to seek unscheduled care.This study was performed to determine whether patients receiving >1 series of viscosupplementation had an increased adverse reaction rate. A retrospective chart review was performed on all patients who received >1 series of viscosupplementation during the study. A local adverse reaction was defined as acute swelling and pain in the knee, with no injury or trauma within 72 hours after hyaluronic acid injection.Twenty-eight knees received >1 series of viscosupplementation. The adverse reaction rate to second series injections was 1.28% (3.57% of knees). The adverse reaction rate to ≥3 series was 0.9% (6.67% of knees). This adverse reaction rate was significantly less than the 21% reported in previous studies for multiple series injections (z=-1.90; P<.05) and is not significantly different than the 2% rate of adverse reactions reported for first series injections. No significant difference existed in the adverse reaction rates between 2 series and ≥3 series of viscosupplementation.The current study suggests that the rate of adverse reaction was low at 1.28% of second series viscosupplementation.
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Webber
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Webber
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Matzkin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000139:chemically induced* / Q000175:diagnosis; D004487:Edema / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055676:Viscosupplementation / Q000009:adverse effects*; D055675:Viscosupplements / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid