Viscosupplementation
Viscosupplementation is a procedure that can help restore and increase the cushioning and lubrication of the knee joint. Viscosupplementation has been studied as a treatment for osteoarthritis since the 1970s. This procedure is not a cure for osteoarthritis of the knee but rather a treatment that may reduce or eliminate osteoarthritic pain. The procedure involves three injections of a hyaluronic acid preparation into the knee joint over a two week span. Hyaluronic acid is a naturally occurring substance found in joint fluid, also known as synovial fluid. It acts as a lubricant for the joint cartilage and enables bones to move smoothly over each other. Additionally it serves as a shock absorber for joint loads. People with osteoarthritis (“wear-and-tear” arthritis) have a lower-than-normal concentration of hyaluronic acid in their joints and therefore might benefit from viscosupplementation therapy.
Treatment
Viscosupplementation has been shown to relieve pain in many patients who did not get relief from non medicinal measures or analgesic drugs. Two preparations of hyaluronic acid are available: a natural product made from rooster combs, and an artificial one manufactured from bacterial cultures. If you are allergic to egg or poultry products, the natural product should be avoided and the manufactured product should be used instead.
If there is any swelling (effusion) in the knee, your physician will remove (aspirate) the excess fluid before injecting the hyaluronic acid preparation. This is usually done at the same appointment, with only one needle injection into the joint.
Immediate Effects of Viscosupplementation
Hyaluronic acid does not have an immediate pain-relieving effect.
You may notice a local reaction, such as pain, warmth, and slight swelling immediately after the shot. These symptoms generally do not last long. You may want to apply an ice pack to help ease them.
For the first 48 hours after the shot, you should avoid excessive weight bearing on the leg, such as standing for long periods, jogging or heavy lifting.
Longer-term Effects of Viscosupplementation
Over the course of the injections, you may notice that you have less pain in your knee.
Hyaluronic acid does seem to have anti-inflammatory and pain-relieving properties. The injections may also stimulate the body to produce more of its own hyaluronic acid.
Effects may last for several months
Viscosupplementation doesn’t work for everyone. There’s no proof that it will reverse or delay the progression of osteoarthritis. In addition, it can be very expensive and clinical trials have not yet proven that it is cost-effective. If your current course of medication and treatment is working, stay with it. However, if your arthritis isn’t responding well, or if you’re trying to delay surgical intervention, then you may wish to discuss viscosupplementation with your Orthopaedic surgeon.