What Is Viscosupplementation?
In this procedure, a gel-like fluid called hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It acts as a lubricant to enable bones to move smoothly over each other and acts as a shock absorber for joint loads. People with osteoarthritis have a lower than normal concentration of hyaluronic acid in their joints. The theory is that adding hyaluronic acid to the arthritic joint will facilitate movement and reduce pain.
Another name for viscosupplementation is synovial fluid replacement.
What is Viscosupplementation Used For?
Viscosupplements are approved for the treatment of osteoarthritic knee pain. Studies have shown the potential benefit in other joints as well. Viscosupplementation can help reduce inflammation and pain caused by osteoarthritis, increasing mobility and allowing more activity. These treatments can be injected into one or multiple joints such as both knees at the same time.
Who Could Benefit From Viscosupplementation?
Viscosupplementation may be considered if you have not found pain relief from:
- Physical therapy
- Weight loss
- Use of heat (for example, from a heating pad) and cold (for example, from an ice pack)
- Use of a cane or orthotics (such as a heel wedge and other products that relieve the pressure on the knee)
- Use of analgesics, including acetaminophen (for example, Tylenol); aspirin; prescription or nonprescription nonsteroidal anti-inflammatory drugs (NSAIDs).
Viscosupplementation might be right for you if you:
- Are not receiving adequate pain relief from current treatment
- Cannot take aspirin or other anti-inflammatory drugs like ibuprofen
- Are already taking multiple pain medications
- Are not an appropriate candidate for knee surgery or wish to avoid or postpone knee surgery
How is Viscosupplementation Done?
The viscosupplements come in an injectable form. The procedure involves injecting the viscosupplement liquid into the knee with a needle. The viscosupplementation procedure is done in your doctor's office, and only takes a couple of minutes. You may need a series of injections, which are done once per week for three to five consecutive weeks.
What are Some Side Effects of Viscosupplementation?
The most commonly reported side effects associated with the viscosupplementation injections are temporary injection-site pain, swelling, heat and/or redness, rash and itching, bruising around the joint and/or fluid accumulation in the injected knee. These reactions to viscosupplement injections are usually mild and do not last long although occasionally reactions can be severe. You should avoid any strenuous activities or prolonged (more than 1 hour) weight-bearing activities (such as jogging or tennis) for 48 hours following the viscosupplementation injection.
Will Viscosupplementation Cure my Osteoarthritic Knee?
Although some patients report relief of arthritis symptoms with viscosupplementation, the procedure has never been shown to reverse the arthritic process or re-grow cartilage. It will not cure osteoarthritis of the knee. Viscosupplementation simply improves the lubricating properties of the synovial fluid, reduces or stops the pain from knee osteoarthritis, improves mobility and provides a more comfortable level of activity. Viscosupplementation treatment is usually required every 6 months but can sometimes last up to a year.
The effectiveness of viscosupplementation in treating arthritis is not clear. It has been proposed that viscosupplementation is most effective if the arthritis is in its early stages (mild to moderate), but more research is needed to support this. Research in viscosupplementation and its long-term effects continues.
What Additional Health Information Should I Give My Physician Before I Receive the Viscosupplement Treatment?
Before beginning viscosupplement treatment, let your physician know if you are allergic to products from birds (such as feathers, eggs, or poultry).
You should not receive viscosupplement injections if you have a known allergy to sodium hyaluronate preparations or you have an infection or skin disease in the area of the injection site.
For more information on Viscosupplementation ask your physician or call 703-525-2200 to make an appointment with one of our Orthopaedic Surgeons.