Knee Surg Relat Res.  2017 Jun;29(2):129-136. 10.5792/ksrr.16.061.

Hylan GF-20 Viscosupplementation in the Treatment of Symptomatic Osteoarthritis of the Knee: Clinical Effect Survivorship at 5 Years

Affiliations
  • 1Department of Trauma Orthopaedics, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. tboutefnouchet@hotmail.com
  • 2Department of Trauma Orthopaedics, Alexandra Hospital, Redditch, UK.

Abstract

PURPOSE
Controversies remain surrounding the choice of hyaluronic acid products and patient selection. A study was conducted to report the long-term survivorship of intra-articular injection effect of high molecular weight hyaluronic preparation hylan GF-20 (Synvisc-One) for patients with symptomatic knee osteoarthritis.
MATERIALS AND METHODS
A retrospective observational analysis of a single therapeutic series was carried out. The analysis was conducted to determine therapeutic effect survivorship taking arthroplasty and any other surgical interventions as endpoint results.
RESULTS
Seventy-seven consecutive patients (82 knees) were followed up for five years. At one-year follow-up, 71 knees (87%) responded to treatment and only 8 knees (10%) were offered arthroplasty due to persistence of symptoms. At five-year follow-up, 41 (50%) were still considered responders. During the study period, repeat injection was given in 9 knees (11%). Arthroplasty (either total or unicompartmental) was required in 26 (31%). Kaplan-Meier survivorship analysis of therapeutic effect demonstrated 67% survival at 5 years with arthroplasty as endpoint and 58% survival at 5 years with all secondary interventions as endpoint.
CONCLUSIONS
This study demonstrates a significantly longer duration of clinical benefit of hylan GF-20 injection. Present results may suggest a notion of an ideal delay therapeutic strategy for patients not ready to receive an arthroplasty. Further studies will be required to help characterise these subsets of patients.

Keyword

Knee; Osteoarthritis; Intra-articular injections; Viscosupplementation; Hyaluronic acid; Treatment outcome; Survival

MeSH Terms

Arthroplasty
Follow-Up Studies
Humans
Hyaluronic Acid
Injections, Intra-Articular
Knee*
Molecular Weight
Osteoarthritis*
Osteoarthritis, Knee
Patient Selection
Retrospective Studies
Survival Rate*
Treatment Outcome
Viscosupplementation*
Viscosupplements*
Hyaluronic Acid
Viscosupplements
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