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.
Dr. Joseph Guettler, an orthopedic surgeon at William Beaumont Hospital in Royal Oak, Mich., thinks the study is promising. He treats many patients with the study participants' symptoms and has used both arthroscopy and hyaluronate injections, but not together.
"As an orthopedic surgeon, there is consideration [based on this study] for making it automatic [injections]," said Guettler. "My one hesitation is that when you scope a knee, you're running saline through it, cleaning it out, and I do have a hesitation about injecting a foreign substance during surgery." This would slightly increase the risk of infection, he said. He usually uses the fluid during recuperation, if he thinks the patient needs it.
Dr. Howard Luks, chief of sports medicine and arthroscopy at Westchester Medical Center and New York Medical College in Valhalla, N.Y., found the study results limited by the short time that pain was alleviated. Eventually, patients with severe arthritis will need knee replacement surgery, he said, noting that it's best to have the one procedure instead of two, thereby limiting risk of infection and recuperation time.
"Knee replacement is the definitive treatment for this. It's a bigger procedure with longer recovery, but it will ad
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