Colorado Joint Pain Treatments
Viscosupplementation is the process of adding a lubricating, gel-like fluid
into a painful joint to replace lost synovial fluid. This procedure can
replace the fluid lost from the joint due to arthritis, wear-and-tear, and age.
What is hyaluronic acid?
Hyaluronic acid occurs naturally in the body and the synovial fluid. It
serves as a cushion to protect joints from impact and the load. In addition,
it is a lubricating agent that allows the bones to move smoothly across
one another. With viscosupplementation, hyaluronic acid is added back
into the joint to reduce pain, improve movement, and cushion the joint.
Who benefits from viscosupplementation?
Viscosupplementation is used to treat osteoarthritis of the knee, but it
is sometimes used for other joints. Some of the benefits of this procedure include:
- Decreased pain
- Improved walking, standing, and movement
- Possibility of delaying or avoiding surgery
- Improved overall quality of life
How do I prepare for the viscosupplementation procedure?
When you agree to have viscosupplementation, the doctor reviews the procedure
risks and benefits and has you sign a consent form. The doctor will also
ask you questions about your medications, as certain ones thin the blood
and must be held for a few days. The doctor may want to take additional
imaging tests, to assess your joint status.
How is the viscosupplementation done?
The doctor will have you put on a gown so he can access your joint. The
skin is first cleaned with an antiseptic. The skin may be numbed using
an anesthetic, and then the procedure needle is guided into the space
under real-time x-ray. Once position is verified, the hyaluronic acid
is injected. After the needle is removed, the area is covered with a Band-Aid.
Will I have restrictions after the viscosupplementation procedure?
After your knee injection with hyaluronic acid, you should rest for the
remainder of the day. Your knee will be slightly tender at the injection
site. Avoid anti-inflammatory drugs. The joint may feel better immediately,
but results are often not felt for 1-2 days. Avoid strenuous activities,
and gradually return to usual duties.
How often is viscosupplementation done?
The U.S. Food and Drug Administration approved viscosupplements in 1997.
The frequency of the injection depends on the type of product. Options are:
- Euflexxa (sodium hyaluronate) – This brand is given as a 3-dose series
over three weeks. You come to the office once a week for an injection,
and the series lasts for around 6 months.
- Hyalgan (sodium hyaluronate) – This is given in a series as well,
once a week for 5 weeks.
- Orthovisc (high-molecular-weight hyaluronan) – This agent is a 3-
or 4- dose series that is given weekly.
- Supartz (sodium hyaluronate) – Another weekly injection that is given
in a 3-dose series. Supartz offers 3-6 months of pain relief.
- Synvisc-One (hylan G-F 20) – This product is a one-dose injection
that can be given every 6 months.
- Synvisc (hylan G-F 20) – This product is given in a 3-dose weekly
shot series and lasts for up to 6 months.
How effective is viscosupplementation?
Pain relief lasts from 3 to 6 months, with some patients having improvement
for up to a year. It may take a few weeks to notice improvement in the
joint. The maximum benefits are observed around 5 weeks’ post-injection.
Clinical studies have shown that viscosupplementation is beneficial for
people with arthritis. In a recent randomized controlled trial, 71% of
patients were symptom-free at 26 weeks, which was much better than those
who received NSAIDs therapy or placebo.