Reason for visit: Has had constant, progressively increasing pain in her right knee for several years. She resents that osteoarthritis knee pain is forcing her to slow down. Acetaminophen and physical therapy did not provide sufficient relief. She does not want to take more pills in addition to her daily medication for hypertension and hypercholesterolemia. Her daughter is getting married soon and she wants to be able to enjoy it.

Patient Profile

basketball player

Age: 38
Profession: Physical Plant Manager

Reason for visit: Mild knee pain even when at rest...related to prior knee injuries. Would like to repeat 5-injection HYALGAN®, due to previous treatment success.

Health Status

Predisposing factors:
30 lbs overweight; Sedentary lifestyle

Chief Complaints:

Mild to moderate knee pain; knee instability upon walking or getting up out of chair
Concerned about being able to enjoy her daughter's wedding in 6 months

Medical History

Progressive increase in pain, stiffness, and loss of mobility
Radiograph confirms osteoarthritis (OA) of medial side of knee (narrowing of medial joint space and osteophytes)
Physical therapy restored some flexibility without significant improvement in knee pain
History of bleeding peptic ulcer in her 30s
- Anxious about NSAIDs and COX–2–selective inhibitors, even with PPI use; acetaminophen ineffective
- Taking atorvastatin and amlodipine
- Concerned about current number of daily medications; wants to avoid daily systemic pain reliever if possible

Treatment Options

Has not responded well to acetaminophen; NSAIDs are contraindicated because of prior history of ulcer; physical therapy did not relieve pain
Given the options, she was eager to try HYALGAN® 5-injection treatment cycle

Post-treatment Notes

Patient noted gradual relief throughout the treatment cycle
At the end of her 5-injection cycle, patient was pleased with the results of the treatment and looking forward to dancing at her daughter's wedding
Next follow-up visit due 26 weeks post-end of 5th treatment

Health Status

Predisposing factors:
Knee injury in college; meniscal tear repaired with arthroscopic surgery

Chief Complaints:

Mild knee pain becoming worse at end of day; moderate pain affecting mobility at end of work day, during chores at home, and while playing basketball (plays competitively)

Medical History

Knee pain, stiffness, and gradual loss of mobility since predisposing knee injury
Radiographic degenerative changes confirm osteoarthritis (OA)
No significant relief with 3 months of acetaminophen
Exercises regularly; underwent physical therapy; no significant relief after 3 months

Treatment Options

Does not want to rely on OTC/Rx NSAIDS or COX-2-selective inhibitors again
Would prefer another 5-injection treatment cycle with HYALGAN®

Post-treatment Notes

Post 5-injection cycle follow-up, patient returned to his normal active schedule
Next follow-up visit due 26 weeks post-end of fifth treatment.

* These profiles are composites derived from clinical experience. They are not actual patients. Individual results may vary.

When to use HYALGAN®
How to use HYALGAN®

Important Safety Information for HYALGAN®

HYALGAN® is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative nonpha-rmacologic therapy, and to simple analgesics, eg, acetaminophen
HYALGAN® is contraindicated in patients with known hypersensitivity to hyaluronate preparations. Intra-articular injections are contraindicated in cases of past and present infections or skin diseases in the area of the injection site
The effectiveness of a single treatment cycle of less than 3 injections has not been established
In the US clinical trial of 495 patients, the only adverse event showing statistical significance vs placebo was injection-site pain
Other adverse events included gastrointestinal complaints, headache, local ecchymosis and rash, local joint pain and swelling, and local pruritus. However, the incidence of these events was similar in the HYALGAN®-treated and placebo groups
In other clinical studies, the frequency and severity of adverse events occurring during repeat treatment cycles did not increase over that reported for a single treatment cycle

Click here for additional important information for HYALGAN®.