ACUTE LOCAL REACTIONS AFTER INTRAARTICULAR HYLAN FOR OSTEOARTHRITIS OF THE KNEE

Objective. To describe acute local reactions following intraarticular hylan injection and determine their frequency. Methods. Retrospective review of all patients with osteoarthritis of the knee treated with hy lan by 3 rheumatologists. Results. Twenty-two patients had 88 injectio ns to 28 knees. Six patients had reactions within 24 h of injection ch aracterized by pain, warmth, and swelling, lasting up to 3 weeks. This occurrence was unpredictable. Corticosteroid injections were sometime s required. Synovial fluid cell counts were 5.0-75.0 x 10(9)/l, often with a prominent mononuclear component. Crystal studies and cultures w ere negative. Radiographic chondrocalcinosis was present in only 1 pat ient. One patient had serum antibodies to chicken serum proteins. Conc lusion. Intraarticular hylan was associated with significant local inf lammatory reactions in 27% of patients, or 11% of injections. The mech anism(s) and long term sequelae are unclear.