Pseudoseptic reactions to hylan viscosupplementation: diagnosis and treatment.

Victor M Goldberg, Richard D Coutts

Journal: Clinical orthopaedics and related research 2004

PMID: 15021143

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Abstract

Hyaluronans are used widely in the treatment of osteoarthritis of the knee. Three commercial hyaluronan preparations currently are available in the United States: sodium hyaluronate (Hyalgan), sodium hyaluronate (Supartz), and hylan G-F 20 (Synvisc). Although the sodium hyaluronates are derived naturally, hylan is chemically modified to increase its molecular weight. All three products have been shown to be well tolerated in clinical trials, however, there have been reports in the literature of pseudoseptic reactions, or severe acute inflammatory reactions, after injections with hylan. Our study reviewed the reported incidence of pseudosepsis. The pathogenic mechanisms and clinical treatment of this reaction are presented.

Address: Case Western University, Cleveland, OH 44106, USA. [email protected]

DOI: 10.1097/00003086-200402000-00021

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MeSH Terms: Aged, Arthritis, Reactive, Combined Modality Therapy, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Hyaluronic Acid, Incidence, Injections, Intra-Articular, Male, Middle Aged, Osteoarthritis, Knee, Pain Measurement, Prognosis, Range of Motion, Articular, Risk Factors