Osteoarthritis (OA) is the most common form of arthritis. OA is a common problem and is often referred to as ”degenerative joint disease.” In order for joints to move smoothly, they must contain an adequate amount of cartilage and synovial fluid. A healthy joint contains sufficient amounts of cartilage, which acts as a shock absorber, and synovial fluid, a gel-like liquid that reduces friction in the joint. Osteoarthritis results in the wearing of cartilage and a decrease in synovial fluid and its lubricating properties. This typically results in painful rubbing of the bones and restriction in range of motion. Viscosupplementation is a procedure where a gel-like substance called hyaluronic acid is injected into the joint. Hyaluronic acid is naturally found in healthy synovial fluid; for patients who have OA, injecting hyaluronic acid increases lubricating and shock absorbing properties of the joint. This often results in improvement of pain and range of motion.
Viscosupplementation can be used with several other non-surgical treatments for osteoarthritis to help improve symptoms. Some of these include:
- Oral or topical medications
- Physical therapy
- Steroid injections
- Activity modification
- Ice/heat application
Although these conservative treatments do not cure osteoarthritis, they can relieve pain, improve mobility and delay the need for surgery.
Viscosupplementation injections are done in the office setting. The area of injection is first cleansed and any excess joint fluid is removed with a syringe. The joint is then injected with hyaluronic acid. The injection is routinely given under the guidance of ultrasound to ensure that the needle is inserted accurately. Most patients may have viscosupplemation injections every 6 months.
Immediately following the injection, you may experience a fullness feeling in the joint. Occasionally, patients experience a temporary increase in pain, swelling, or warmth to the joint after injection. This usually resolves within 24-72 hours, symptoms can be reduced with ice application and elevation.
Viscosupplementation is usually a safe and non-invasive treatment procedure. However, as with most treatment procedures, injection is rarely associated with certain complications. The risks and complications that could be associated with these injections include:
- Increased pain at the injection site
- Tissue damage
- Injury to neighboring nerves
Undergoing the procedure under the hands of a skilled medical provider can greatly minimize these risks.