The use of hylan G-F 20 after knee arthroscopy in an active patient population with knee osteoarthritis

Patrick M Zietz, Harlan Selesnick
Arthroscopy 2008, 24 (4): 416-22

PURPOSE: The purpose of this study was to evaluate the efficacy of hylan G-F 20 when used to treat an active and athletic patient population with knee osteoarthritis who had undergone knee arthroscopy for mechanical symptoms.

METHODS: We performed a prospective evaluation of patients who underwent knee arthroscopy for mechanical symptoms. All patients had Outerbridge grade III or IV changes to their articular cartilage. If patients complained of residual pain or activity limitations postoperatively that was believed to be from osteoarthritis, they were treated with a series of hylan G-F 20 consisting of 3 weekly injections. International Knee Documentation Committee (IKDC) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores are reported for the time immediately before arthroscopy, at the time of the first hylan G-F 20 injection (baseline), at 3 months postoperatively, and at 6 months postoperatively. In addition, activity scores were calculated from a subset of the IKDC questionnaire before arthroscopy, at baseline, and at 3 months postoperatively.

RESULTS: Fifteen patients completed 6 months' follow-up. Baseline and 3- and 6-month IKDC and WOMAC scores were significantly improved compared with before arthroscopy. There was no significant difference in 3- and 6-month scores compared with baseline. The activity scores at baseline and at 3 months showed significant improvement compared with before arthroscopy. The activity scores also showed significant improvement at 3 months compared with baseline.

CONCLUSIONS: Hylan G-F 20 injections allow for improved activity levels at 3 months' follow-up. There was not a significant benefit of the injections when IKDC and WOMAC scores were evaluated. Hylan G-F 20 may be more beneficial for those patients who desire to increase their activity level rather than those who wish to decrease their pain.

LEVEL OF EVIDENCE: Level IV, therapeutic case series.

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