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  • Title: Intra-articular injection of high molecular weight hyaluronan after arthrocentesis as treatment for rheumatoid knees with joint effusion.
    Author: Tanaka N, Sakahashi H, Sato E, Hirose K, Ishima T, Ishii S.
    Journal: Rheumatol Int; 2002 Aug; 22(4):151-4. PubMed ID: 12172954.
    Abstract:
    OBJECTIVE: The aim of this study was to find if a complete synovial fluid aspiration before injection of intra-articular high molecular weight hyaluronan influences the treatment result for knees with rheumatoid arthritis (RA), including joint effusion and the prognostic factors related to clinical effect. METHODS: The arthritic knees including effusion were randomized to arthrocentesis or no arthrocentesis before the hyaluronan (1.9-2.5 x 10(6)) was injected into knee joints five times every week. All patients were followed up for 6 months. RESULTS: One hundred eighteen RA patients (80 knees in the arthrocentesis group, 81 knees in the no-arthrocentesis group) were included. The proportion of no relapses in the arthrocentesis group was higher than that in the no-arthrocentesis group. In the arthrocentesis group, regression analysis showed that duration of knee arthritis (<5 months), CRP (<4 mg/dl), and Larsen grade (<grade II) were the significant predictors. CONCLUSIONS: Arthrocentesis is effective in reducing the risk for arthritis relapse by intra-articular hyaluronan injection to rheumatoid knees with joint effusion. Predicting responders are duration of knee arthritis, CRP, and radiological scores.
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