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Published on: April 26, 2024
Management of knee osteoarthritis: knee lavage combined with hylan versus hylan alone
Vijay B Vad1, Atul L Bhat, Thomas P Sculco
1Hospital for Special Surgery, New York, NY 10021, USA. vadv@hss.edu
Objective:
To assess the difference in efficacy between knee lavage plus the standard hylan G-F 20 (a derivative of hyaluronan) protocol and the standard hylan G-F 20 as per standard usage protocol alone for the treatment of knee osteoarthritis (OA).
Design:
Nonrandomized prospective study in which patients chose their treatment group. Follow-up averaged 1.1 years.
Setting:
Faculty practice of a single physician at a major teaching hospital.
Participants:
Eighty-one patients with documented knee OA on magnetic resonance imaging.
Interventions:
Group 1 (n=44) received a single-needle lavage 1 week before the standard hylan G-F 20 protocol; group 2 (n=37) received the standard hylan G-F 20 protocol alone.
Main Outcome Measures:
Pre- and posttreatment scores on the Lysholm-II Questionnaire and a visual analog scale (VAS) were documented for each patient. The Wilcoxon signed-rank test was used for statistical analysis.
Results:
A successful outcome was noted in 79.5% of group 1 patients and in 54% of group 2 patients (P<.05).
Conclusions:
In the management of knee OA, the use of knee lavage before viscosupplementation with hylan G-F 20 yields better results than using hylan G-F 20 alone. The presence of radiologic grade IV knee OA or moderate to severe patellofemoral arthritis are negative prognostic factors.