Severe Acute Localized Reactions Following Intra-Articular Hyaluronic Acid Injections in Knee Osteoarthritis
| Autor: | Edmund Lau, Roy D. Altman, Kevin L. Ong, Zhimin Xiao, Maria Runa, Wilson Ngai |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Biomedical Engineering Physical Therapy Sports Therapy and Rehabilitation Osteoarthritis Injections Intra-Articular Viscosupplementation chemistry.chemical_compound Intra articular Adjuvants Immunologic Adrenal Cortex Hormones Hyaluronic acid Humans Immunology and Allergy Medicine Hyaluronic Acid Aged Aged 80 and over Inflammation business.industry Anti-Inflammatory Agents Non-Steroidal Middle Aged Osteoarthritis Knee medicine.disease Treatment Outcome chemistry Anesthesia Female business Arthrocentesis |
| Zdroj: | CARTILAGE. 13:1474S-1486S |
| ISSN: | 1947-6043 1947-6035 |
| Popis: | Objective Concerns have been raised about severe acute localized reactions (SALR) following intra-articular (IA) hyaluronic acid (HA) injections for knee osteoarthritis (OA). We compared surrogate SALR measures between hylan G-F 20 and non-hylan G-F 20 HA patients and evaluated corresponding SALR risk factors for hylan G-F 20 patients. Design Knee OA patients were identified from the Optum Clinformatics dataset (January 2006 to June 2016), stratified into hylan G-F 20 and non-hylan G-F 20 HA users. Occurrences of surrogate SALR measures including inflammation/infection, intra-articular corticosteroid (CS) injections, arthrocentesis/aspiration, and office visits were evaluated within 3 days of HA use. Risk factors were evaluated using logistic regression. Results The cohort involved 748,428 HA patients (23.2% in the hylan G-F 20 group). Inflammation/infection rate was 0.001% for hylan G-F 20 and 0.002% for non-hylan G-F 20 HA groups. Risk of CS injection (any diagnosis) was greater for hylan G-F 20 patients by 28% ( P < 0.001). Combined rates of CS injection and arthrocentesis/aspiration (any diagnosis) were comparable for both groups (hylan G-F 20, 2.2%; non-hylan G-F 20 HA, 2.6%). The risk of any visit or studied responses was lower for the hylan G-F 20 cohort by 12% ( P < 0.001). Clinical characteristics, such as CS injections within 1 week before HA and fluoroscopic imaging, were associated with the outcomes. Conclusions The diagnosis of inflammations or infections within 3 days of the HA injection was extremely rare. The overall risk of surrogate SALR measures was similar for hylan G-F 20 and non-hylan G-F 20 HA patients. |
| Databáze: | OpenAIRE |
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