Injections May Boost Knee Surgery Success

MSN (HealthDay News)—January 28, 2010  January 29, 2010 

For people with arthritis, injections of a nonsteroidal anti-inflammatory fluid can improve recovery from arthroscopic knee surgery to repair damaged cartilage, researchers say.

Studies have shown that hyaluronic acid products can reduce arthritis pain and improve functioning for patients who do not respond to standard anti-inflammatory medications.

"They [patients] had better pain relief and better functional mobility when we combined surgery with the injections," said study leader Dr. Geoffrey Westrich, co-director of Joint Replacement Research at Hospital for Special Surgery.

Almost 16 million Americans between 25 and 74 have osteoarthritis, according to background information in the study. And many have torn or debilitated knee cartilage (meniscus), requiring surgery. The meniscus pad functions like a shock absorber between the femur (thigh bone) and tibia (shin bone). When it decays, bone friction can cause extreme pain and loss of functioning.

The presence of arthritis in patients with meniscus tears impedes knee surgery outcomes, and the study authors wanted to know if combining injections with surgery would improve results.

Their findings were published recently in the American Journal of Orthopedics.

In the study, 46 patients over the age of 40 were divided into two groups. One group received three injections of Hyalgan, one immediately following surgery, the others two and three weeks after the procedure. The other group had surgery but no injections. Factors that could affect the outcome, such as age and weight, were controlled.

Six months after surgery, 53 percent of the control group had significant pain on motion, but only 5 percent of the study group did. Those injected with Hyalgan also had significantly more flexibility.

Westrich said he believes that these results will help surgeons who discover during surgery that the patient has some arthritis, which doesn't always show on x-rays or MRIs ahead of time.

"The important point is that surgeons, when they encounter arthritis during surgery, they should consider injecting the knee with Hyalgan," said Westrich. Further studies are needed to determine whether the improvements are long-lasting, he added.