Viscosupplementation Treatment for Knee Arthritis

Osteoarthritis of the knee is extremely common; usually slowly developing over time with increasing pain and disability. Unfortunately there is no cure for osteoarthritis, but there are several treatment options available.

In its early stages, arthritis of the knee is treated conservatively.

Methods include:

  • Modifying activities
  • Weight control
  • Pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
  • Physical therapy
  • Injection therapy: Corticosteroid injections, platelet rich plasma, orthokine and stem cell therapy.

Another treatment option is a procedure called viscosupplementation.

In this procedure, a gel-like fluid called hyaluronic acid is injected into the knee joint.

  • Very importantly, prior to any injection therapy being performed a patients particular case would be evaluated and discussed and the best treatment option suggested.

Why inject hyaluronic acid?

Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It is thought to act as a lubricant, enabling smooth movement of the joint and acting as a shock absorber.

We know that people with arthritis have a lower-than-normal concentration of the substance in their joints. The theory behind injecting hyaluronic acid is that it artificially replaces the substance, thus reducing pain and increasing movement.

Viscosupplementation has been around for more than 20 years, and is approved by the Therapeutic Goods Administration (TGA) in Australia. This is available at your local pharmacy, however, requires a script.

Procedure

Although there are several products available, at Independent Sports Imaging we tend to use SynviscOne (hylan G-F 20). We may use other products due to referring practitioner preference.

The procedure involves a single treatment session with one injection into the joint.

For the first 48 hours after the injection, one should avoid excessive weight bearing on the leg, such as standing for long periods, jogging or heavy lifting.

Side Effects / Complications

Some people in the first 48 hours get a local reaction, such as pain, warmth, and slight discomfort which generally does not last long. If necessary paracetamol or Ibuprofen may be of use. Using an ice pack may also be of help. Less than 2% of patients get pain, swelling, heat, redness or fluid build-up in or around the knee.

Rarely a patient may develop a local allergy-like reaction in the knee, with acute redness and swelling.

Outcomes

Usually, pain relief starts at about one month post procedure and lasts up to 6 months.

Like all forms of therapy, not everybody will respond well to this therapy and in some patients there be no improvement at all.

Reference article / Product website:

  1. Chevalier X, Jerosch J, Goupille P, et al. Single, intra-articular treatment with 6 ml hylan G-F 20 in patient’s symptomatic primary osteoarthritis of the knee; a randomised, multicentre, double-blind, placebo controlled trial. Ann Rheum Dis. 2010; 69(1):113-119. doi:10.1136/ard.2008.094623.
  1. Synvisc-One website, please click on this link: synviscone.com
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Credentials

Dr Berman is a dual specialist – Musculoskeletal Radiologist and Vein Specialist (Phlebologist)
Please click on Specialist Vein Care to see dedicated website.