Author/Authors :
Uchôa de Rezende, Márcia Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil , Melo Campos Gurgel, Henrique Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil , Pereira Ocampos, Guilherme Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil , Constantino de Campos, Gustavo Universidade Estadual de Campinas, Campinas, SP, Brazil , Frucchi, Renato Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil , Felício Pailo, Alexandre Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil , Pasqualin, Thiago Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil , Ricardo Negreiros Vicente, José Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil , Pires de Camargo, Olavo Universidade de São Paulo - Hospital das Clínicas - Medical School, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil
Abstract :
Objective: To verify whether the use of Hylan G-F20 improves saline
lavage and triamcinolone injection results in the treatment of hip
osteoarthritis (HOA). Methods: 82 patients with HOA categorized as
grades II and III severity, according to Kellgren and Lawrence criteria,
were randomized into the groups: lavage and triamcinolone (G0);
lavage, triamcinolone, and 2 mL of hylan G-F20 (G1); lavage, tri-
amcinolone, and 4mL of hylan G-F20 (G2); lavage, triamcinolone,
and 6mL of hylan G-F20 (G3). The VAS, range of motion (ROM),
WOMAC, and Lequesne questionnaires were administered at
baseline, one, three, six, and twelve months post-injection. Results:
All groups showed clinically relevant improvements (> 20%) between
baseline and first month post-injection, maintaining subjective results
throughout the study period (p < 0.001). We found no differences
between groups in any subjective evaluations (p > 0.05, for all).
G2 and G3 obtained improved flexion results up to a year (p = 0.028).
Hylan groups presented an improved external rotation since the
first postoperative month and maintained the results up to a year
(G1, p = 0.041; G2, p = 0.007), whereas G0 showed no improvement
(p = 0.336). Conclusion: Hip lavage and triamcinolone injection, with
or without the use of hylan, improves pain, function, and quality of
life up to a year in HOA. Hylan may improve ROM up to one year.
Level of Evidence IB, Randomized clinical trial.
Keywords :
Hyaluronic Acid , Viscosupplementation , Triamcinolone , Osteoarthritis , Hip , Randomized Controlled Trial , Minimal Clinically Important Difference