Effects of intra-articular hylan G-F 20 injections on clinical and biomechanical characteristics of the knee in osteoarthritis

• Published in: International journal of rehabilitation research Vol. 28; no. 4; p. 371
• Main Authors: Yavuzer, Güneş, Sonel, Birkan, Süldür, Nurben, Ergin, Süreyya
• Format: Journal Article
• Language: English
• Published: England 01.12.2005
• Subjects: Aged; Biomechanical Phenomena; Female; Gait - drug effects; Health Status; Humans; Hyaluronic Acid - analogs & derivatives; Hyaluronic Acid - pharmacology; Hyaluronic Acid - therapeutic use; Injections, Intra-Articular; Knee Joint - drug effects; Male; Middle Aged; Osteoarthritis, Knee - drug therapy; Osteoarthritis, Knee - physiopathology; Pain - drug therapy; Pain Measurement; Treatment Outcome
• ISSN: 0342-5282; 1473-5660
• DOI: 10.1097/00004356-200512000-00013

The objectives of this study were to investigate the effects of Hylan G-F 20 (Synvisc; Genzyme Biosurgery, Ridgefield, New Jersey, USA) injections on clinical and biomechanical gait characteristics of patients with knee osteoarthritis. The design was a before-after trial, set in the gait laboratory of the rehabilitation unit of a university hospital. Twelve patients participated with an average age (+/-SD) of 63.2+/-4.4 years, and Kellgren and Lawrence grade II or III knee osteoarthritis. The main outcome measures were the Western Ontario McMaster Universities Osteoarthritis Index, and time-distance, kinematic and kinetic parameters of gait. The intervention used was a single course of three bilateral intra-articular injections of 2 ml Hylan G-F 20. One week after the treatment, the pain subscore and total score of WOMAC decreased from 9.2+/-2.7 to 4.8+/-3.1 and from 42.1+/-15.2 to 37.9+/-13.5, respectively. There was improvement in sagittal plane excursions of the knee (from 40.2+/-8.1 to 43.3+/-8.5), in extensor and adductor moments (from 0.26+/-0.2 to 0.14+/-0.1 and from 0.45+/-0.1 to 0.41+/-0.1, respectively), and in scaled vertical forces (from 85.8+/-4.5 to 88.4+/-5.4). All these differences were statistically significant. In conclusion, intra-articular Hylan G-F 20 injections not only decrease pain in patients with knee osteoarthritis, but can alter the natural history of the disease by decreasing excessive loads in the knees.