PR_053: Functional Outcomes Improve With Hylan G-F 20 in Patients With Knee Osteoarthritis

Abstract

Objective: To determine whether hylan G-F 20 (Synvisc) improves function when used to treat osteoarthritis (OA) knee pain. Design: Review of randomized, controlled, prospective clinical studies (with n>100 patients) that measured functional outcomes. Setting: Orthopedic clinics. Participants: Patients with knee OA. Interventions: Hylan G-F 20, intra-articular placebo, intra-articular corticosteroid, appropriate or conventional care, progressive knee exercises, and nonsteroidal anti-inflammatory drugs (NSAIDs). Main Outcome Measures: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) domain C (physical function), 36-Item Short-Form Health Survey (SF-36) physical component, and extent of patient’s activity loss with difficult tasks, activity restriction, walking distance, and range of motion (ROM). Results: In 8 prospective, randomized, controlled trials (1675 total patients), hylan G-F 20 improved function in patients with knee OA. WOMAC domain C and SF-36 physical component were significantly better with hylan G-F 20 than appropriate care at 12 months (P<.000). WOMAC domain C was also significantly better with hylan G-F 20 than conventional treatment at 9 months (P=.000) or intra-articular triamcinolone hexacetonide at 12 and 26 weeks after treatment (P≤.001). In 1 study, WOMAC domain C was similar between hylan G-F 20, sodium hyaluronate, and placebo. In another study, however, the extent of the patient’s activity loss with difficult daily tasks was significantly better with hylan G-F 20 than with intra-articular saline from weeks 1 to 26 (P range, .004−.000). Finally, hylan G-F 20 improved similarly from baseline for WOMAC domain C compared with diclofenac, for walking distance and ROM versus progressive knee exercises, and in activity restriction compared with NSAIDs or hylan G-F 20+NSAIDs. Conclusions: Patients experience improvements in functional outcomes when given hylan G-F 20 for the treatment of OA knee pain.