VIENNA — Ultrasound-guided intraarticular injection of hylan G-F 20 (Synvisc) in patients with hip osteoarthritis is safe, well tolerated, and results in reduced pain and improved function for up to 9 months post injection, Alberto Migliore, M.D., reported at the annual European Congress of Rheumatology.
Synvisc, a hyaluronan derivative, is injected in order to supplement synovial fluid that has lost its elastoviscosity due to osteoarthritis.
It is used routinely in patients with symptomatic knee osteoarthritis, a setting in which multiple studies have shown that the treatment provides pain relief with a low risk of adverse events.
Fewer data are available regarding Synvisc in hip osteoarthritis, in large part because hip injections are technically more difficult and require ultrasound guidance in order to achieve consistently good results, explained Dr. Migliore of San Pietro Hospital, Rome.
He reported on 223 patients with symptomatic hip osteoarthritis who received one or more intraarticular 2-mL Synvisc injections.
Sixty-two had bilateral hip osteoarthritis. Patients were followed for up to 9 months. They could receive a repeat injection every 3 months as needed. A total of 360 injections were administered.
Nineteen patients left the study in order to undergo hip replacement surgery.
Significant improvement occurred in all three study end points: osteoarthritis pain as self-assessed on a visual analog scale, need for nonsteroidal anti-inflammatory drugs, and clinical improvement as measured using the Lequesne index. (See chart.)
No local infections or systemic adverse events occurred.
The injection technique involved the use of a sterile biopsy guide attached to a 3.5-MHz convex or 7-MHz linear ultrasound transducer. The joint was imaged using an anterior parasagittal approach.
Now that the safety and efficacy of intraarticular Synvisc injections have been demonstrated in hip osteoarthritis, Dr. Migliore's next goals are to establish the optimal dosing regimen and determine whether the therapy exerts a disease-modifying effect.