Factors Associated with Knee Arthroplasty in a Knee Osteoarthritis Patient Cohort Treated with Intra-articular Injections of Hylan G-F 20.

Hylan G-F 20 viscosupplementation can be used to treat knee osteoarthritis pain. This study evaluated time to knee arthroplasty (KA), KA risk factors, and health care resource utilization in patients aged ≥18 years with claims in the Optum Clinformatics Data Mart database (2006-2016) for knee osteoarthritis treated with at least one course of hylan G-F 20. Kaplan-Meier analysis estimated KA risk from osteoarthritis diagnosis and first hylan G-F 20 treatment. KA risk factors were determined using multivariate Cox regression. Among 62,033 patients treated with hylan G-F 20 and/or hylan G-F 20 single intra-articular injection, 60 to 64% did not undergo KA 8 years following first injection. KA risk factors from time of osteoarthritis diagnosis and first hylan G-F 20 treatment were similar: increased age, fewer comorbidities, fewer hylan G-F 20 treatments, female sex, and no ultrasound/fluoroscopy for injection guidance. Patients who underwent KA versus those who did not had more office visits and claims for opioids, nonsteroidal anti-inflammatory drugs, and physical therapy. Patients less likely to undergo KA were younger (<40 years), had more comorbidities, received more courses of hylan G-F 20, were males, or received ultrasound/fluoroscopic injection guidance. Patients who did not receive KA versus those who did used fewer health care resources.

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K.O. reports grants and nonfinancial support from Sanofi U.S., during the conduct of the study; other from DJO, other from Zimmer Biomet, other from Ethicon, other from Ossur, grants from Stryker, grants from Ferring Pharmaceuticals, grants from Medtronic, grants from Paradigm Spine, grants from Pacira Pharmaceuticals, grants from St Jude Medical, grants from Relievant Medsystems, other from Joerns Healthcare, other from SpineFrontier, and other from Karl Storz Endoscopy-America outside the submitted work. E.L. reports grants and nonfinancial support from Sanofi U.S., during the conduct of the study; grants from Stryker Orthopedics, grants from Boston Scientific, grants from Medtronic, grants from Relievant Medsystem Inc., grants from Ferring Pharmaceutical Inc., and grants from Alcon Inc. outside the submitted work. M.R. reports grants and nonfinancial support from Sanofi U.S. during the conduct of the study.W.D. reports personal fees, nonfinancial support, and other from Sanofi during the conduct of the study.R.A. reports nonfinancial support from Sanofi during the conduct of the study; personal fees from Ferring, personal fees from Flexion, personal fees from GSK, personal fees from Novartis, personal fees from Oletec, personal fees from Oriko, personal fees from Pfizer, and personal fees from Theralogix outside the submitted work.