Whether you injured your knee through playing sports, an accident, or just developed knee pain with time, knee osteoarthritis can make getting through your day a painful chore. Your knee may be difficult to move, stiff, or even locked.
In a normal, healthy knee joint, each end of the joint bones is coated with a cushioning tissue called cartilage and surrounded with lubricating synovial fluid. The cartilage helps absorb shocks and prevents the knee bones from rubbing against one another. The thick, viscous synovial fluid allows your bones to glide smoothly, so that bending and flexing your knee is easy and pain-free.
If you have osteoarthritis, your cartilage is damaged and your synovial fluid is less effective and less lubricating.
Our expert rheumatologists at Rheumatology Center of New Jersey may recommend viscosupplementation injections to replace lost synovial fluid and help your knee move freely again. Viscosupplementation injections are minimally invasive and are the treatment of choice after lifestyle modifications, physical therapy, and other therapies have failed to bring you relief.
Your synovial fluid is made of a lubricating substance called hyaluronic acid (HA), as well as lubricin, proteinases, and collagenases. Hyaluronic acid has a viscous, gel-like consistency, similar to that of egg whites. When you have osteoarthritis, the amount of HA in your synovial fluid decreases, so it doesn’t do a good enough job of lubricating your joint.
If our rheumatologists think you’re a candidate for viscosupplementation, they inject HA directly into your knee joint to restore the viscosity of your synovial fluid. Depending on your needs, your doctor gives you one to five HA injections, spaced one week apart, over a period of several weeks.
The HA injections take several weeks to improve your pain. In a saline (placebo) controlled trial, 62% of women and men who received HA viscosupplementation had significantly less pain when walking after just four weeks, and 71% had less pain after eight weeks. Relief lasted up to six months.
Your rheumatologist administers viscosupplementation as an outpatient procedure, using a local or topical anesthetic. If you have any built-up fluid in your knee, your doctor first removes it by aspirating it with a syringe.
After your rheumatologist injects the HA viscosupplementation in your knee joint, you should limit your use of your knee to gentle walking and sitting. Avoid weight-bearing activities for 48 hours, including:
Expected side effects are slight swelling, warmth, or pain in the injection site. These should resolve within hours or days. You can control discomfort with over-the-counter pain medications and by icing the injection site with a wrapped ice pack for no more than 20 minutes per hour.
Don’t give up on your knee. If other treatments haven’t relieved your knee pain, contact us today to see if you’re a candidate for viscosupplementation. Call our office or use the online booking form.