Utilization of Hyaluronate and Incidence of Septic Knee Arthritis in Adults: Results from the Korean National Claim Registry.
BACKGROUND
Septic arthritis of the knee has been reported recently in adult patients who were administered hyaluronate. We evaluated the incidence of septic knees and the utilization of hyaluronate in the Korean adult population using nationwide data from the Health Insurance Review and Assessment Service (HIRA).


METHODS
All new admissions to the clinics or hospitals for septic knees were recorded in the HIRA database which was established by the Korean government and covers the Korean population using the International Classification of Diseases-10 revision code. We evaluated the incidence of septic arthritis of the knees in the population above 50 years of age. Hyaluronate prescription data was also collected from the HIRA database.


RESULTS
In 2012, the incidence of septic knees was 2.7 per 100,000 persons in men and 4.2 per 100,000 persons in women, respectively. The age-adjusted incidence of septic knees increased by 6.7% per year (95% confidence interval, 3.3 to 10.1), and the annual number of prescriptions of hyaluronate increased about 1.5-fold during the study period.


CONCLUSIONS
Cautious aseptic technique is required when hyaluronate is administered in adult patients with osteoarthritis of the knee due to the concerns of the risk of septic arthritis.
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Young-Kyun
YK
Lee
Department of Orthopedic Surgery, Dankook University School of Medicine, Cheonan, Korea.
Ki-Choul
KC
Kim
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
Yong-Chan
YC
Ha
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Kyung-Hoi
KH
Koo
D001170:Arthritis, Infectious / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D007270:Injections, Intra-Articular / Q000009:adverse effects* / Q000706:statistics & numerical data; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy; D056910:Republic of Korea / Q000453:epidemiology
D006820:Hyaluronic Acid
Arthritis; Hyaluronic acid; Knee; Septic