Doctor Biehl

Viscosupplementation Treatment for Arthritis

Viscosupplementation Treatment for Arthritis

The first line of treatment for osteoarthritis of the knee aims to relieve pain. Normally, Dr. Biehl will recommend pain relievers such as ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs). If that fails, injections of a corticosteroid into the joint to decrease the pain and inflammation may be tried . However, some people have a reaction to NSAIDs and these agents may bring only temporary pain relief. When conservative measures fail, surgery may be required. Now there are viscosupplementation injections that may be tried before going to surgical intervention.

A squeaking metal hinge can be treated with a drop of oil, so it makes sense that a hinge joint, like the knee, would also benefit from a little lubrication. At least that's the premise behind one new form of treatment for arthritis of the knee. The procedure, called viscosupplementation, injects a preparation of hyaluronic acid into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial (joint) fluid. However, people with osteoarthritis ("wear-and-tear" arthritis) have a lower-than-normal concentration of hyaluronic acid in their joints. Viscosupplementation may be a therapeutic option for individuals with osteoarthritis of the knee. Viscosupplementation helps to restore the smooth gliding function, and improve the biochemical environment of the knee joint.

Viscosupplementation has been shown to relieve pain in many patients who did not get relief from other nonmedicinal measures or analgesic drugs. The technique has been used in Europe and Asia for several years, but the U.S. Food and Drug Administration did not approve it for treating osteoarthritis of the knee until 1997. Two preparations of hyaluronic acid are available-a natural product made from rooster combs, and an artificial one manufactured from bacterial cultures. One injection is given per week for three to five weeks depending on the product used. Results are variable and dependent on the degree of osteoarthritis present. Success tends to increase with milder forms of arthritis. When symptomatic improvement occurs, significant relief of symptoms can last for six months or longer. The series of injections, if successful, may be repeated every 6 months and are covered by most insurance.

When you receive an injection of Hyaluronic acid, you may notice a local reaction, such as pain, warmth, and slight swelling immediately after the shot. These symptoms generally do not last long. For the first 48 hours after the shot, you may want to avoid excessive weightbearing on the leg, such as standing for long periods, jogging or heavy lifting. In additon, you may want to apply an ice pack to help ease the symptoms. Fortunately, most patients do not experience any adverse reactions. Corticosteroids frequently give quick pain relief. Hyaluronic acid does not give the quick pain relief. Over the course of the injections, you may notice that you have less pain in your knee. It may take 4-6 weeks to experience the maximum pain relief. Hyaluronic acid does seem to have anti-inflammatory and pain-relieving properties. The injections may also stimulate the body to produce more of its own hyaluronic acid. The beneficial effects may last for several months.

If your current course of medication and treatment is working, stay with it. However, if your arthritis isn't responding well, or if you're trying to delay an inevitable surgery, you may wish to discuss this option with Doctor Biehl.



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