VISCOSUPPLEMENTATION WITH HYLAN FOR THE TREATMENT OF OSTEOARTHRITIS -FINDINGS FROM CLINICAL-PRACTICE IN CANADA

Objective. To evaluate viscosupplementation with intraarticular hylan G-F 20 in current clinical practice. Methods, A retrospective study of all patients with osteoarthritis of the knee treated with hylan by 5 Canadian clinicians over a period of 2.5 years. Results, A total of 15 37 injections were performed in 336 patients involving 458 knees. The overall response and the change of activity level were judged better o r much better for 77 and 76% of the treated knees after the first cour se of treatment (3 weekly injections), and 87 and 84% after a 2nd cour se. The mean time elapsing between the first and 2nd course, 8.2 +/- 0 .5 months, is an evaluation of the duration of benefits. Local adverse events were observed in 28 patients (32 knees), with an overall rate of 2.7% adverse events per injection, 7.0% per joint, and 8.3% per pat ient. No systemic adverse events were noted in any patient. The advers e events were characterized by pain and/or transient swelling of the i njected joint, mostly mild or moderate in intensity, and 72% of the ad verse events were considered to be possibly or probably related to the injection. The incidence of adverse events is significantly influence d by the injection technique: 5.2% adverse events per injection with a medial approach to a partially bent knee, and 2.4% (straight medial) and 1.5% (straight lateral), After an adverse event, clinical improvem ent still occurred in 69% of the affected knees. Conclusion, Hylan G-F 20 provided good clinical benefits and an acceptable safety profile i n current clinical practice. The occurrence of adverse events after an intraarticular hylan injection is infrequent and unpredictable and is not necessarily hylan related, although injection related.