Viscosupplementation As A Treatment for Knee Osteoarthritis
Osteoarthritis (OA) is a degenerative joint disease that is sometimes called “wear and tear” arthritis. It’s the most common chronic condition of the joints and occurs when the surface layer of cartilage breaks down. In a healthy knee, cartilage allows bones to glide over one another and acts as a shock absorber. In addition to cartilage, a normal knee joint also contains synovial fluid - a thick, gel-like substance that cushions the joint and further reduces friction by acting as a lubricant. It’s the combination of cartilage deterioration and reduction of synovial fluid that contributes to the symptoms of OA: pain, stiffness, limited range of motion and inflammation.
Viscosupplementation is a procedure which addresses one of the factors that contribute to OA symptoms: reduction of synovial fluid. This treatment involves injecting a viscous liquid, hyaluronic acid (HLA), into the afflicted knee. HLA is a naturally occurring component of synovial fluid.
In the US, the three HLA based products are Hyalgan, Synvisc, and Supartz. The frequency of injections will depend on the product used. With Synvisc, your knee must be injected three separate times, each one week apart. For Hyalgan and Supartz, five separate injections are required, also given a week apart. If the injections are effective, they may be repeated after a period of time, which is usually 6 months.
During the procedure, if there is any swelling in the knee, your doctor will aspirate the excess fluid before injecting the hyaluronic acid product. Typically, the injection is done using only one needle, but some doctors may prefer to use two separate syringes.
It is recommended that for the first 48 hours after the injection, you avoid excessive weight bearing on the leg, such as standing for long periods, jogging or heavy lifting.
While some people experience significant relief of OA symptoms with viscosupplementation, the procedure can’t reverse cartilage damage. For those who do experience relief, it may take several weeks to notice improvement.
The effectiveness of viscosupplementation in treating OA is mixed. It’s been suggested that the procedure is most effective in mild to moderate cases. For those who are not receiving adequate pain relief from current treatment, cannot take NSAIDs, or aren’t appropriate candidates for knee surgery, viscosupplementation is an alternative worth considering.
Talk to your healthcare provider about viscosupplementation and how it can benefit your OA treatment plan.