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Objective: To assess the difference in efficacy between knee lavage plus the standard hylan G-F 20 (a derivative of hyaluronan) protocol and the standard hylan G-F 20 as per standard usage protocol alone for the treatment of knee osteoarthritis (OA)., Design: Nonrandomized prospective study in which patients chose their treatment group. Follow-up averaged 1.1 years., Setting: Faculty practice of a single physician at a major teaching hospital., Participants: Eighty-one patients with documented knee OA on magnetic resonance imaging., Interventions: Group 1 (n=44) received a single-needle lavage 1 week before the standard hylan G-F 20 protocol; group 2 (n=37) received the standard hylan G-F 20 protocol alone., Main Outcome Measures: Pre- and posttreatment scores on the Lysholm-II Questionnaire and a visual analog scale (VAS) were documented for each patient. The Wilcoxon signed-rank test was used for statistical analysis., Results: A successful outcome was noted in 79.5% of group 1 patients and in 54% of group 2 patients (P<.05)., Conclusions: In the management of knee OA, the use of knee lavage before viscosupplementation with hylan G-F 20 yields better results than using hylan G-F 20 alone. The presence of radiologic grade IV knee OA or moderate to severe patellofemoral arthritis are negative prognostic factors.

Athletes participating in contact sports or activities, such as excessive running, are at higher risk for the development of knee osteoarthritis. Newer minimally invasive, nonsurgical treatment options, and medications in the management of knee osteoarthritis, have enabled many athletes with knee osteoarthritis to regain most of their mobility. These new treatments have no down time and, when combined with proper rehabilitation protocol, have helped patients to regain and maintain their mobility gains and overall quality of their life. In the years to come newer technologies, such as autologous cultured chondrocyte implantation, tissue engineered cartilage, growth factors, and acellular matrices, may play an important role in the management of knee osteoarthritis.