Viscosupplementation with hylan G-F 20 (Synvisc): pain and mobility observations from 74 consecutive patients

Seventy-four patients (120 knees, 360 injections) referred to an orthopedic surgery clinic by their primary care physician for osteoarthritis knee pain received 3 weekly intra-articular injections of hylan G-F 20 (Synvisc; Genzyme Biosurgery, Ridgefield, NJ). Osteoarthritic knee pain, the ability to perform activities, and the amount of pain medication, physiotherapy, and assistive device use were prospectively evaluated 1 month and 1 year after treatment. The majority of patients reported improved or much improved pain at 1 month (99%) and 1 year (91%) after hylan G-F 20 therapy. Patient activity was similarly improved in the majority of patients at 1 month (99%) and 1 year (69%) following physiotherapy. Of the 120 knees treated with hylan G-F 20, pain relief >6 months was reported for 62% of knees. Use of analgesics, nonsteroidal anti-inflammatory drugs, intra-articular steroids, physiotherapy, and assistive devices was reduced with hylan G-F 20 for 75%-100% of patients at 1 month, and was sustained at 1 year in the majority of patients (78%-94%) for the use of analgesics, steroids, and physiotherapy. Three (4%) patients experienced erythema and irritation at the injection site that resolved within 48 hours and did not interfere with the remaining injections. Hylan G-F 20 effectively and safely relieves osteoarthritis knee pain, facilitates an improved activity level, and decreases the need for pain medication, physiotherapy, and assistive devices.