Successful nonoperative management of chronic osteoarthritis pain of the knee: Safety and efficacy of retreatment with intra-articular hyaluronans

Mark Pagnano, Geoffrey Westrich

Research output: Contribution to journalReview article

62 Scopus citations

Abstract

Context: Although there are many nonsurgical therapies available for the treatment of pain associated with osteoarthritis (OA), their long-term use and safety have not been systematically followed. Intra-articular hyaluronan therapy has been used in the treatment of symptoms associated with OA of the knee with a very favorable safety profile. Five intra-articular hyaluronan products are approved in the US. No systematic review of the safety and efficacy of their chronic use has been reported. Objective: To evaluate the literature on the efficacy and safety of repeat courses of hyaluronan therapy in patients with OA of the knee. Data sources: MEDLINE, EMBASE, searched through October 2004. Study selection: Databases were searched using the terms hyaluronan, sodium hyaluronate, hyaluronic acid, hylan, hylan G-F 20, osteoarthritis, adverse events, repeat treatment, and multiple courses. Data synthesis: There are some data that support the benefit and safety of repeat treatment for all products. Data also indicate that one formulation of sodium hyaluronate (molecular weight [MW] 500-730 kDa) is well tolerated and as effective after multiple courses of treatment as it is after a single course. There is also clinical evidence that prolonged use of sodium hyaluronate (MW 500-730 kDa) may significantly decrease the rate of deterioration of joint structure. Localized severe acute inflammatory reactions reported with repeated treatment in some patients are not a class effect but may be linked to physicochemical characteristics of hylan-based treatment. Conclusions: Repeat courses of the hyaluronans are safe and effective in the treatment of pain associated with OA of the knee.

Original languageEnglish (US)
Pages (from-to)751-761
Number of pages11
JournalOsteoarthritis and Cartilage
Volume13
Issue number9
DOIs
StatePublished - Sep 1 2005

Keywords

  • Hyaluronan
  • Hyaluronic acid
  • Hylan G-F 20
  • Osteoarthritis
  • Repeat treatment
  • Sodium hyaluronan
  • Sodium hyaluronate

ASJC Scopus subject areas

  • Rheumatology
  • Biomedical Engineering
  • Orthopedics and Sports Medicine

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