Factors Associated with Knee Arthroplasty in a Knee Osteoarthritis Patient Cohort Treated with Intra-articular Injections of Hylan G-F 20

Abstract

Hylan G-F 20 viscosupplementation can be used to treat knee osteoarthritis pain. This study evaluated time to knee arthroplasty (KA), KA risk factors, and health care resource utilization in patients aged ≥18 years with claims in the Optum Clinformatics Data Mart database (2006–2016) for knee osteoarthritis treated with at least one course of hylan G-F 20. Kaplan–Meier analysis estimated KA risk from osteoarthritis diagnosis and first hylan G-F 20 treatment. KA risk factors were determined using multivariate Cox regression. Among 62,033 patients treated with hylan G-F 20 and/or hylan G-F 20 single intra-articular injection, 60 to 64% did not undergo KA 8 years following first injection. KA risk factors from time of osteoarthritis diagnosis and first hylan G-F 20 treatment were similar: increased age, fewer comorbidities, fewer hylan G-F 20 treatments, female sex, and no ultrasound/fluoroscopy for injection guidance. Patients who underwent KA versus those who did not had more office visits and claims for opioids, nonsteroidal anti-inflammatory drugs, and physical therapy. Patients less likely to undergo KA were younger (<40 years), had more comorbidities, received more courses of hylan G-F 20, were males, or received ultrasound/fluoroscopic injection guidance. Patients who did not receive KA versus those who did used fewer health care resources.

Intra-articular Hyaluronic Acid for Osteoarthritis of the Knee in the United States: A Systematic Review of Economic Evaluations

“…Several studies evaluated the impact of knee OA treatment with IAHA on time to TKA. [23][24][25][26][27] Each of these studies concluded that the use of IAHA is associated with longer time to TKA (Table 2). A retrospective analysis of data from 2006 to 2016 in the Optum Clinformatics database by Ong et al 25 reported a longer median time to TKA of ~7 months for those who received IAHA versus those who did not.…”

“…This finding was confirmed in a second retrospective analysis of the Optum Clinformatics database (data from 2006 to 2016) in which the median time from first IAHA treatment to TKA was ~6 months with 1 treatment and approximately 4 years with ⩾5 treatments. 27 Altman et al 23 found that IAHA injections are associated with dose-dependent increase in time to TKA: the mean time to TKA for patients receiving no IAHA was 0.7 years and was 3.6 years for patients who received ⩾5 courses.…”

Efficacy of hydrotherapy versus gym treatment in primary total knee prosthesis due to osteoarthritis: a randomized controlled trial

“…Los principales síntomas que caracterizan a la OA son el dolor, la rigidez, la incapacidad funcional, la inestabilidad articular y la inflamación 3 . El resultado de toda esta sintomatología es una disminución de la calidad de vida, un aumento del riesgo de la morbimortalidad y un mayor coste sanitario 4 .…”