Chronic Knee Effusions in Patients With Advanced Osteoarthritis –Implications for Functional Outcome of Viscosupplementation

David D. Waddell; Andrew A. Marino

doi:10.1055/s-0030-1248040

The Journal of Knee Surgery, Inhaltsverzeichnis

J Knee Surg 2007; 20(3): 181-184
DOI: 10.1055/s-0030-1248040

Original Article

Chronic Knee Effusions in Patients With Advanced Osteoarthritis – Implications for Functional Outcome of Viscosupplementation

David D. Waddell^1, ² , Andrew A. Marino^2, ³

¹Orthopedic Specialists of Louisiana, Louisiana State University Health Sciences Center, Shreveport, La
²The Department of Orthopedic Surgery, Louisiana State University Health Sciences Center, Shreveport, La
³The Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, La

Abstract

ABSTRACT

Intra-articular injection of exogenous hyaluronan (viscosupplementation) is an effective treatment for knee pain due to osteoarthritis, but the amount of dilution of the viscosupplement by the synovial fluid, which could affect efficacy, has not been previously considered. In this study, the synovial fluid volume was measured in patients with advanced osteoarthritis and the variation in viscosupplement concentration that would have occurred had the patients received that treatment was calculated. A closed aspiration was performed under anesthesia in this consecutive, prospective series of patients undergoing total joint arthroplasty for advanced osteoarthritis. Any remaining synovial fluid was collected by means of open aspiration following an arthrotomy. Overall, 27.0±15.5 mL (range: 10-70 mL) of synovial fluid was present in the joints. Irrespective of the particular proprietary hyaluronan product, the viscosupplement concentration would have varied by an approximate factor of 6. Interpatient variation in volume of synovial fluid may explain some of the observed variations in efficacy in patients treated with viscosupplementation. Stricter attention to the possibility of a joint effusion and aspiration of the joint where indicated might lead to improved results.

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