Hyaluronic Acid Injection in OA: Viscosupplementation

VISCOSUPPLEMENTATION:  TREATMENT FOR OSTEOARTHRITIS OF KNEE JOINT

• To relieve pain  is the first line of treatment in osteoarthritis of knee. Drugs like ibuprofen, (NSAIDS) along with physical therapy, topical analgesics and injection of corticosteroids are usually given for pain relief.
• Viscosupplementation is a new procedure in which a preparation of hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid. It is a lubricant which makes the movement at the joints smoother and also acts as shock absorber for the joint loads.
• Low concentration of hyaluronic acid within the  joints is seen in patients with osteoarthritis. So viscosupplementation May be a therapeutic option for individuals with osteoarthritis.

EFFECTS OF VISCOSUPPLEMENTATION

• It has been  effective for pain relief in many patients who don’t respond to drugs or physical therapy.  The technique has been used in Europe and Asia for several years, but the U.S. Food and Drug Administration did not approve it until 1997, and now approved only for treating osteoarthritis of the knee. Several preparations of hyaluronic acid are now commercially available.

• Immediate effects:
  1. Soon after the injection there can be a short period of pain,warmth and swelling. Which usually resolve by applying ice packs.
  2. There is no immediate pain relief.
  3. Avoid excessive weight bearing on the leg like standing for long time, weight lifting, jogging, etc.

• Long term  Effects:
  1. Pain relief
  2. It also stimulate body to produce  more of its own hyaluronic acid.
  3. Effects last for months.

TREATMENT

•  Before injecting the hyaluronic acid into the joint space any effusion should be aspirated, which can be done with the same injection needle. Depending on the product used, you will receive 3 to 5 shots over several weeks. Recently an injection is given as a single shot

OUTCOME:

• The use of viscosupplements seems t be helpful for people who are not responding to basic treatment. It is most effective if the arthritis is in its early stages (mild to moderate). Some patients may feel pain at the injection site, and occasionally the injections result in increased swelling.
• If your arthritis is not responding well or if you are trying to delay surgery, you may wish to discuss this option with your orthopaedic surgeon.