Retrospective study of outcomes in Hyalgan®-treated patients with osteoarthritis of the knee

Objective: To evaluate therapeutic success [defined as lack of total knee replacement surgery (TKR) or other significant clinical intervention during a 6-month follow-up] and to identify baseline patient and disease characteristics associated with improved pain relief and quality of life (QOL) in patients in a clinical practice who were treated with a single course of Hyalgan(R) (intra-articular hyaluronan) for pain associated with ostecarthritis (OA) of the knee. Design and setting: This was an uncontrolled, retrospective study conducted at a single US clinical orthopaedic practice. Patients: 248 patients with moderate to severe OA of the knee. Intervention: All patients received a single course of intra-articular Hyalgan(R) therapy during an 18-month period, and had a radiogram of the treated knee within the 6 months before treatment. Results: A total of 218 of 363 (60.1%) knees (248 patients) with moderate to severe OA were judged successfully treated over a 6-month follow-up period; only 20.3% of cases required TKR. On the basis of a multivariate analysis that correlated improvements in pain and QOL assessed by a retrospective questionnaire with baseline patient and disease characteristics, taller patients (>165 cm), patients with less severe OA, and patients with patellofemoral compartment involvement had the greatest improvement in pain relief and quality of life following treatment with Hyalgan(R). Conclusions: Hyalgan(R) was effective in patients with moderate to severe OA, and may have delayed TKR in 80% of patients. Taller patients, patients with less severe OA, and patients with patellofemoral compartment involvement showed the greatest pain relief and improvements in QOL.