Improvements in Hip Osteoarthritis with Lavage, Triamcinolone and Hylan G-F20

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, triamcinolone, 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 (px003E;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.