HIGHER BODY MASS INDEX IS ASSOCIATED WITH WORSE CLINICAL OUTCOMES OF HYLAN G-F 20 INJECTIONS IN THE SHOULDER AND HIP JOINTS OF PATIENTS WITH OSTEOARTHRITIS

POSTER PRESENTATIONS

Background. Intra-articular hyaluronan injections are approved by the Food and Drug Administration for the management of knee osteoarthritis. The effectiveness and safety of use of viscosupplementation in other joints are still unclear, and no evidence-based criteria are established to screen the patients for such treatment. Research Question. The effectiveness and safety of the use of viscosupplementation for the management of osteoarthritis of the shoulder and hip. Protocol/Methods. In a case series study, we retrospectively reviewed the charts of the 26 patients undergoing fluoroscopically-guided intra-articular Hylan G-F 20 injections for the management of osteoarthritis of the shoulder (21 injections) and hip (31 injections). Age, gender, body mass index, number of co-morbidities, use of opiates, severity, and location of osteoarthritis were assessed as possible prognostic factors. The number of months of pain relief and the degree of symptomatic improvement were considered outcomes for this study. Results. Our analysis showed that the injections provide effective pain relief for up to 4 months in 72 approximately half of the patients with a few patients experiencing pain relief during the whole observation period of 24-30 months. No adverse events were reported. We have also found statistically significant association of a higher body mass index with worse clinical outcome - shorter duration of pain relief and less symptomatic improvement in both joints. We did not find significant prognostic factors (i.e., age, race, the number of comorbidities, use of opiates, and the location (hip versus shoulder) and severity of degenerative joint disease) for the clinical outcomes of injections. Discussion. Our results point towards a strong relationship between positive responses to intra-articular Hylan G-F 20 injections performed using fluoroscopic guidance in individuals with lower BMI who suffer from intractable shoulder and/or hip OA-related pain. Conclusion. Intraarticular Hylan G-F 20 injections for the symptomatic management of shoulder and hip osteoarthritis appear to be safe with better efficacy in lean individuals regardless of severity.