What is viscosupplementation?
The joints of people with osteoarthritis or other degenerative joint diseases are different in several ways from those of healthy people. They contain less synovial fluid (the oily liquid which lubricates joints), and that fluid is thinner and therefore less able to lubricate nicely.
Viscosupplementation entails the supplementation of the defective matrix of the joint with material of high viscosity and elasticity, namely Sodium Hyaluronate. When injected into the joint, it provides protection, lubrication, shock absorption and restoration of the viscosity of synovial fluid.
By supplementing the patient’s natural lubricants, hyaluronate injection may reduce pain and stiffness in the treated joints for easier, more comfortable movement. A number of studies in Canada and Europe have shown the beneficial effects of Viscosupplementation in the management of osteoarthritis.
What is sodium hyaluronate?
Sodium Hyaluronate is an important component of synovial fluid and provides it with its lubricating properties. It also acts as a shock absorber during movement such as walking down the staircase.
Sodium Hyaluronate is injected intra-articularly into the synovial cavity of a joint.
What makes me a good candidate for hyaluronate injection?
Hyaluronate injection is particularly useful for patients in relatively early stages of osteoarthritis, where physical damage has not progressed very far. It can also be used as an alternative or supplement to therapy with non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics, the medications most often prescribed for arthritis patients.
If you are unable to tolerate or you do not wish to take NSAIDs , hyaluronate injection may be an appropriate therapy. If you have recently been diagnosed as having osteoarthritis, hyaluronate injection may be appropriate if your doctor has decided that your current therapy needs to changed or enhanced.
How is hyaluronate injection administered?
Hyaluronate injection is given to the joints. More than one joint may be treated at the same time.
More injections may be given in chronic conditions. It is available only through a healthcare professional.
How long will the benefits of the hyaluronate injection last?
This form of treatment appears to be effective in more than 75% of patients after one course, and in 84% of cases after the second course of therapy. The effectiveness of therapy was evaluated by assessment of patient activity, and decreased use of concomitant therapy. Majority of patients experience clinical benefits lasting from 6 to 12 months. The clinical outcomes also depend on the severity of symptoms. Those with more severe condition would benefit from additional injections.
What are the advantages of the hyaluroate injection?
Sodium Hyaluronate (Hyaluronic Acid) is the natural substance of the joint. It is injected to the joint space and works only locally within the joint, thus there have been no reported systemic reactions related to the treatment. This is different from those medication such as pain-killer known as Nonsteroidal anti-inflammatory drugs (NSAIDs) which can cause gastro-intestinal bleeding or ulcer.
Viscosupplementation is one of the recommended choice for Osteoarthritis treatment according to the American College of Rheumatology Subcommittee on Osteoarthritis Guidelines of the Knee year 2000.
Is hyaluronate injection painful?
Naturally, as with all injections, there may be a mild and short-lasting discomfort during the actual procedure., but aside from this it is virtually painless.
Often your doctor may use a topical anaesthetic to reduce the discomfort. If there is considerable inflammation around the joint, the doctor may remove some of the excess fluid (aspirate) prior to an injection of Sodium Hyaluronate. Viscosupplement injection is only administered when joint swelling disappeared.
What precautions should I take after the hyaluronate injection?
You should rest and avoid strenuous weight-bearing activities for 1-2 days after an injection.