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Repeat That Knee Injection, Please!

Injecting a lubricating fluid made from chicken combs has proven helpful for some people with knee osteoarthritis. An injectable drug called Hylan GF-20 is now on the market. A series of three to five weekly injections is given directly into the joint. The injections can give pain relief and increased knee mobility for up to six months. But if symptoms return, can the injections be used again?

Doctors are looking into this question. There is some concern that a local reaction may occur with more than one series of injections. There have been reports of pain, swelling, and loss of motion with this drug. Sometimes, patients can't put weight on their leg because of severe pain.

Research at the William Beaumont Army Medical Center in Texas is being done in this area. Two groups of adults with knee osteoarthritis received Hylan GF-20. One group had a single series of three injections. The other group had two or three more sets of injections. The group with the extra injections had eight times more local reactions than those who only had one set of injections.

Some patients who initially get relief from the injections may want to use them again. However, they should be aware that a reaction to the drug may occur. Repeated injections that cause joint pain, and swelling can otherwise be treated with steroid medication. At this point, there isn't enough research to tell patients not to try the injections a second or third time. They must be alerted, however, about possible problems when making this decision.

References: Seth S. Leopold, MD, et al. Increased Frequency of Acute Local Reaction To Intra-Articular Hylan GF-20 (Synvisc) in Patients Receiving More Than One Course of Treatment. In The Journal of Bone and Joint Surgery. September 2002. Vol. 84-A. No. 9. Pp. 1619-1623.

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