Article
Role of hylan G-F 20 in treatment of osteoarthritis of the hip joint1

Presented as a poster at the American Academy of Orthopaedic Surgeons’ 68th Annual Meeting, February 28–March 4, 2001, San Francisco, CA.
https://doi.org/10.1016/S0003-9993(03)00140-0Get rights and content

Abstract

Vad VB, Sakalkale D, Sculco TP, Wickiewicz TL. Role of hylan G-F 20 in treatment of osteoarthritis of the hip joint. Arch Phys Med Rehabil 2003;84:1224–6.

Objective:

To study the efficacy of hylan G-F 20 in the treatment of osteoarthritis (OA) of the hip joint.

Design:

Prospective within-group study.

Participants:

Twenty-two patients (25 hips) with hip joint OA who had failed to find pain relief from conservative methods such as physical therapy, exercises, and steroid injections. Demographics included 14 men and 11 women (mean age, 56.4y), 21 of whom had mild to moderate OA and 4 of whom had severe OA of the hips.

Intervention:

Each hip joint was injected with 2mL of hylan G-F 20 at 2, 3, and 4 weeks and fluoroscopic lavage with 100mL of normal saline at week 1. All patients had standard hip exercise regimen after the injection.

Main Outcome Measures:

American Academy of Orthopaedic Surgeons (AAOS) Lower Limb Core Scale score and visual numeric pain score.

Results:

At 1-year follow-up, the AAOS Lower Limb Core Scale score improved from a preinjection mean of 44.2 to a follow-up mean of 86.1 (P<.05). The mean visual numeric pain score improved from a preinjection mean of 8.7 (range, 6.4–10) to a follow-up mean of 2.3 (range, 0–7.2). The overall success rate was 84%. In patients with mild to moderate OA, the mean pain score decreased from a preinjection value of 7.8 to a follow-up value of 1.7. The success rate was 90.5% in that subgroup. In patients with severe OA, the mean pain score decreased from a preinjection value of 9.1 to a follow-up value of 3.8. The success rate was 50% in that subgroup. There were no complications related to the injection.

Conclusion:

Use of hylan G-F 20 injection is a viable option for treatment of mild to moderate OA of the hip joint.

Section snippets

Methods

Twenty-five osteoarthritic hip joints in 22 patients were selected for study from the patient population at the rehabilitation clinic at our institution from 1998 to 2000. The demographics included 14 men and 11 women, with a mean age of 56.4 years (range, 39–72y). Inclusion criteria were demonstration of hip OA on plain radiography and magnetic resonance imaging (MRI) and failure of all conservative methods, including physical therapy, anti-inflammatory medications, and fluoroscopically guided

Results

The mean AAOS Lower Limb Core Scale score improved from a preinjection mean of 44.2 (range, 29.1–57.2) to a follow-up mean of 86.1 (range, 71.3–99) (P<.05). Mean visual numeric pain score improved from a preinjection mean of 8.7 (range, 6.4–10) to a follow-up mean of 2.3 (range, 0–7.2). The overall success rate was 84%.

In patients with mild to moderate OA, the mean pain score decreased from a preinjection value of 7.8 to a follow-up value of 1.7. The success rate was 90.5%.

In patients with

Discussion

Hyaluronic acid is an integral part of the connective tissue system. In synovial joints, it forms an important component of the synovial fluid, which contributes to its viscosity, protection of the superficial layer of articular cartilage, and mechanical shock absorption.5

These properties led to the favorable results of intra-articular injections of hyaluronic acid in osteoarthritic knees.2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Results of hyaluronic acid substitutes like hylan G-F 20 have been quite

Conclusion

Hyaluronic acid compounds such as hylan G-F 20 may benefit select patients with mild to moderate OA of the hip joint, when combined with a structured exercise regimen. More studies, including randomized controlled trials, are required to further substantiate the efficacy of this form of treatment.

References (22)

  • E.A. Balazas

    The physical properties of synovial fluid and the special role of hyaluronic acid

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