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Archive for the ‘Viscosupplementation’ Category

Knee Injection

Knee Injection

What is viscosupplementation?

Hyaluronic acid injections are referred to as viscosupplementation.  This osteoarthritis treatment option injects a substance similar to synovial fluid into the knee joint.  This helps lubricate the knee and acts like a shock absorber.

Hyalgan, Synvisc, and Supartz are the brand names of popular pharmaceutical products containing hyaluronic acid.

These injections for the knee help relieve  joint pain, but for an undetermined amount of time.  Orthopedic surgeons have no way of looking at a patient and knowing if this treatment option will be effective.

The Academy of Orthopedic Surgeons say on their website that hyaluronic acid does not offer immediate pain relief and that local reactions like pain, warmth, and swelling directly after the injection are common.  Patients should avoid jogging, heavy lifting, or excessive weight-bearing activities for at least 2 days following viscosupplementation treatment.

This arthritis treatment option is best suited for people who suffer from mild to moderate osteoarthritis looking for short-term pain relief.

intra-articular hyaluronic acid

intra-articular hyaluronic acid

This post is part of a series about the American Academy of Orthopedic Surgeons’ (AAOS) Full Treatment Guideline for Knee Osteoarthritis.

Recommendation 16 – The AAOS cannot recommend for or against the use of intra-articular hyaluronic acid for patients with mild to moderate knee osteoarthritis.

42 trials examined the effectiveness of viscosupplementation.  The evidence was graded as inconclusive because the importance of the results are clinically unclear.

This is a continuation of our series on the Osteoarthritis Research Society International (OARSI) recommendations for the management of hip and knee osteoarthritis published in the Journal of Osteoarthritis and Cartilage.

Hyaluronate Injection

Intra-articular injections of hyaluronate may be useful in patients with hip and knee osteoarthritis.

Hyaluronate is characterized by delayed onset, but it works longer for symptomatic pain relief when compared to injections of corticosteroids.  Injections of hyaluronate in the knee supplement existing synovial fluid with gel-like substances.

A comprehensive industry-sponsored review of 40 placebo-controlled trials involving viscosupplementation found improvements in pain.  No major safety issues were detected but adverse events such as transient pain at the injection site were reported.

The research team gave this osteoarthritis treatment option a Strength of Recommendation score of 64%.

W. Zhang Ph.D., Moskowitz M.D., et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage. (2008) 16, 137-162.