TOC | Rheumatology
Osteoarthritis Management See Pain / NSAID Med
ACP Library on Disk 2- (c) 1997 - American College of Physicians
New Horizons in the Treatment of Osteoarthritis of the Knee - JAMA 3/10/1999;281 (10):876 Robert F. LaPrade
Viscosupplementation with Intraarticular hylan G-F 20 for the treatment of osteoarthritis: findings from clinical practice in Canada.
Lussier A, Cividino AA - J Rheumatol 1996 Sep;23(9):1579-85
A total of 1537 injections were performed in 336 patients involving 458 knees.
The overall response and the change of activity level were judged better
or much better for 77 and 76% of the treated knees after the first course
of treatment (3 weekly injections), and 87 and 84% after a 2nd course. 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 patient. No systemic adverse events
were noted in any patient. The adverse events were characterized by pain
and/or transient swelling of the injected joint, mostly mild or moderate
in intensity, and 72% of the adverse events were considered to be possibly
or probably related to the injection. The incidence of adverse events is
significantly influenced 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 improvement
still occurred in 69% of the affected knees. CONCLUSION:
Hylan G-F 20 provided good clinical benefits and an acceptable safety profile in 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.
Is glucosamine an effective treatment for osteoarthritic pain? (Cleveland Clinic J Med 6-2001)