Viscosupplementation Treatment for Arthritis

The bones that make up your joints usually have a cap of cartilage on their ends. This cartilage helps your bones move smoothly against each other. This cartilage has a coating of fluid. This coating contains hyaluronic acid. This works like a lubricant and shock absorber in your joint. If you have osteoarthritis, this cartilage cap breaks down over time. This happens because of wear and tear. This causes the bones of your joint to scrape together.

People with osteoarthritis often have less hyaluronic acid in their joints than they should. All of this causes symptoms such as pain, stiffness, and swelling. Replacing hyaluronic acid may help reduce symptoms. Arthritis is often treated with medicines and corticosteroid injections. But if these have not worked well enough, viscosupplementation may help reduce your pain, stiffness, and swelling. It works best for people with mild or moderate osteoarthritis. Hyaluronic acid injection is most often done in the knee.

All procedures have some risks. The risks of this procedure include:

• Flare-up of symptoms just after the injection that lasts for a short period of time (most common)

• Bleeding

• Allergic reaction

• Pain at the injection site

• Infection

• Not enough relief of symptoms

Your own risks may vary according to your health and how often you get injections.

Before your procedure, tell your healthcare provider:

• What medicines you take. This includes prescription medicines and over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements.

• If you’ve had recent changes in your health. This includes an infection or fever. Your shot will need to be delayed if you have an infection in your joint.

• If you are sensitive or allergic to anything. This includes medicines, latex, tape, and anesthetic medicines.

You may want to wear loose clothing. This is so that you can easily expose your joint. Your healthcare provider might give you other instructions about how to get ready.

It is a quick procedure. It may be done during a normal office visit. In general, you can expect the following:

• The knee or other area where you’ll have your shot will be cleaned.

• The healthcare provider may inject a local pain medicine (anesthetic) into the area around your joint. This is so you won’t feel any pain in the area during the treatment. Or your healthcare provider may use an anesthetic spray.

• Your healthcare provider may use imaging. This may be done with ultrasound or a device that shows continuous X-rays. This is so they can inject into just the right spot.

• If you have extra fluid in your joint, your provider may remove a small amount of it.

• Your healthcare provider will inject the hyaluronic acid into the joint space. This is done with a syringe and needle. You may have a shot in more than one spot.

• A small bandage will be put on the injection site.

You should be able to go home shortly after your shot. Ask your healthcare provider if it’s OK for you to drive.

You may have slight pain, warmth, and swelling right after the shot. These symptoms often don’t last long. Using an ice pack may help. Follow all your healthcare provider's instructions about medicines. For the next 48 hours, don't:

• Stand for long periods
• Walk a lot
• Jog or run
• Lift anything heavy

The shot won’t ease your symptoms right away. It may take several weeks before you begin to feel a difference. Your relief from symptoms may last for several months.

Your treatment may include more shots over the next weeks. Make sure to keep all of these appointments. The procedure may not work well if you don’t have the full series of shots. Tell your healthcare provider if the shots are not easing your symptoms. If the treatment does work, you may have more shots in about 6 months or so.

Call your healthcare provider if any of these occur:

• Symptoms don’t go away soon

• Severe warmth, redness, or pain in the joint

• A high fever