Osteoarthritis is among the leading causes of disability in the United States. It is a condition that affects practically every joint of the body and is caused by the slow deterioration of cartilage and thus joint space. This decrease in joint space then leads to bone rubbing on bone which can cause significant pain. There is no cure for osteoarthritis, however, a variety of treatment options are available to help people with osteoarthritis manage pain and stay active.
First line therapy for osteoarthritis involves a variety of nonsurgical methods. Lifestyle modifications including changes in activity level and weight loss are often addressed. Physical therapy is another key component in the therapy of osteoarthritis as are oral and injected pain medications. When these are not completely successful in relieving pain and restoring function, another treatment option is viscosupplementation.
What is Viscosupplementation?
Viscosupplementation is a therapeutic injection that is frequently used to treat osteoarthritis. Although it was only approved for treatment of mild osteoarthritis of the knee by the FDA in 1997, it has been used in Asia and Europe for years and several preparations of it are available commercially. Viscosupplementation involves injecting a gel-like fluid called hyaluronic acid into the knee joint. This hyaluronic acid is normally found in the synovial fluid that surround healthy joints. It works as a shock absorber and lubricant allowing bones to move smoothly over each other. Those with osteoarthritis have very low amount of it in their joints. By injecting more hyaluronic acid into arthritic joints the hope is joints will be able to move more smoothly, pain will be reduced and functionality increased.
There are several different viscosupplements commercially available for treatment of osteoarthritis of the knee. Depending on which product is used, the treatment typically requires a series of injections given one to five times over a few weeks to months. Some may not feel significant improvement until after the first injection or two.
The procedure is done in the clinic with only local anesthetic. If there is any swelling in the knee, excess fluid will be removed before injecting the hyaluronic acid. The aspiration and the injection are typically done using only one needle although some providers may prefer to use two separate syringes. Movement of the knee is recommended to help disperse the viscosupplement, however, it is recommended that you avoid excessive weight bearing on the leg such as standing for long periods, jogging or heavy lifting for the few days.
For those who report pain relief with the procedure, it may take several weeks to notice an improvement. However, for those who do respond, they often find pain relief and improved function for months after the series of injections. If the injections are effective they may be repeated after a period of approximately 6 months.
*Individual Result May Vary*