Study evaluates improvements in hip osteoarthritis with lavage, triamcinolone and hylan G-F20

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Created On: 21/01/2021

Study evaluates improvements in hip osteoarthritis with lavage, triamcinolone and hylan G-F20

A prospective, double-blind, randomized clinical study was carried to explore whether the usage of hylan G-F20 improves saline lavage and triamcinolone injection results in combating hip osteoarthritis.

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Key take away

In patients with hip osteoarthritis, hip lavage followed by triamcinolone injection, with or without the usage of hylan G-F20 enhances the quality of life and function and alleviates short and long-term pain for up to one year. Range of motion may be enhanced for a longer duration (one year) by the addition of hylan.

Background

Method

Overall, 82 subjects having hip osteoarthritis categorized as grades II and III severity, based on Kellgren and Lawrence criteria, were randomly assigned into the cohorts: (i) Lavage and triamcinolone (G0, n=19); (ii) Lavage, triamcinolone, and 2 ml of hylan G-F20 (G1, n=19); (iii) Lavage, triamcinolone, and 4 ml of hylan G-F20 (G2, n=22); and (iv) Lavage, triamcinolone, and 6 ml of hylan G-F20 (G3, n=22).

At baseline, 1, 3, 6, and 12 months after injection, the visual analog scale (VAS), range of motion (ROM), Lequesne questionnaires, and Western Ontario and McMaster Universities (WOMAC) were assessed.

Result

All the treatment arms displayed substantial improvements (> 20%) between baseline and the first month after injection, maintaining subjective outcomes throughout the trial. No vital differences were observed between the cohorts in any subjective assessment. G2 and G3 procured enhanced flexion outcomes for up to a year.

The hylan recipients illustrated an enhanced external rotation since the first postsurgery month and maintained the outcomes up to a year, whereas G0 did not display any improvement. The dose of triamcinolone and local anesthetics should be minimized to prevent noxious effects, and the optimal hylan G-F20 single-dose seems to be greater than 2 ml.

Conclusion

Hip lavage followed by triamcinolone injection, with or without the use of hylan yields satisfactory outcomes in patients suffering from hip osteoarthritis.