Viscosupplementation

Definition

Viscosupplementation is a treatment procedure recommended in patients who are suffering from degenerative conditions such as osteoarthritis. For this procedure, the doctor will inject hyaluronic acid directly into the affected joint. It is known that the patients who suffer from osteoarthritis have reduced levels of hyaluronic acid in the affected joints (this substance commonly exists in the joints of the body, contributing to the lubrication process). Apart from lubricating the joints, the hyaluronic acid also acts as an absorber of shocks, protecting the respective joints.

This procedure is recommended as a conservative treatment in patients who have been diagnosed with osteoarthritis of the tibio-femoral joint. It is the preferred method of symptomatic treatment when aspiration and corticosteroid injections have failed to provide the desired results. In deciding to recommend viscosupplementation, the doctor will take into consideration a series of factors, such as: there are no other joint problems causing the pain, the patient is not scheduled to undergo total knee replacement procedure (for the following six months) or there are no contraindications for this procedure (infection in the respective joint, hemorrhage or infection of the skin in the respective area).

How does Viscosupplementation work?

As it was already mentioned, viscosupplementation works by lubricating the affected joints with hyaluronic acid. The substance is directly injected into the joints, which allows for its rapid absorption and immediate effects. The hyaluronic acid lubricates the joints, improving the symptoms experienced by the patients diagnosed with osteoarthritis and other degenerative conditions.

Before actually injecting the hyaluronic acid, the doctor will check to see if there is excess fluid in the respective joint. If there is excess fluid in the joint, the doctor will first remove it and then inject the hyaluronic acid. Several visits to the doctor will be required, so as to obtain an improvement of the symptoms you experience. On average, between three to five injections with hyaluronic acid are required. Keep in mind that the injections are going to be made one week apart, so as to provide the best outcome for your condition.

Is it effective?

It is important to understand that viscosupplementation cannot cure osteoarthritis. But, when it comes to improving the symptoms experienced by the patients diagnosed with osteoarthritis, viscosupplementation is highly effective. Studies performed on patients who have received injections with hyaluronic acid have clearly demonstrated its efficiency. Viscosupplementation seems to be the most effective in patients who suffer from mild or moderate cases of osteoarthritis.

The effectiveness also varies from one patient to the other. Some patients might notice an improvement of their symptoms in the first weeks, while for other this treatment might not work at all. In general, the procedure can be repeated every six months.

One of the most important benefits of viscosupplementation is the pain relief brought to the patients suffering from osteoarthritis. In the majority of the patients who undergo such procedures, the pain relief is obtained in a couple of weeks (so one should not expect an immediate relief from the pain). Relief from the pain can be obtained between the third and the fifth injection course; however, most of the patients declare that relief from the pain has been obtained between eight to twelve weeks after the treatment has started.

On a long-term basis, the injections with hyaluronic acid will reduce the pain experienced, improving the overall quality of life for the patient with osteoarthritis. Apart from the analgesic properties, it seems that the hyaluronic acid is also capable of reducing the associated inflammation in the affected joint. The effects of the viscosupplementation procedure last a couple of months, this being the reason why it is recommended to repeat the procedure every six months. It is recommended that, for the next couple of days after the injections, you avoid intense physical effort or bearing weight on the respective joint.

Even though this is an effective procedure, you must always keep in mind that it cannot reverse the cartilage tear or damage in the affected joint, nor can it stimulate the cartilage to grow back. This is a procedure used for the improvements of the symptoms caused by osteoarthritis; it is not meant and cannot cure the condition.

Cost

Depending on the brand of the hyaluronic acid used for the viscosupplementation procedure, you can expect to pay around $300 – $700. Apart from that, you will have to add the fees for the doctor to the overall cost. The overall cost is also influenced by the number visits you will make to the doctor’s office. You can check your insurance policy and see if you are covered for such procedures (partial or complete coverage).

Viscosupplementation Side effects

These are the most common side-effects that can appear after the viscosupplementation procedure:

• Pain to the site of injection
• The area is red and warm to the touch
• Inflammation can be noticed in the affected joint (temporary)
• Skin rash and mild to moderate itchiness
• Bruising around the joint
• Allergic reaction – increased local temperature, redness, intense pain and fluid accumulation in the respective joint (emergency treatment is necessary)
• Rarely – infection or hemorrhage.

With the exception of the rare complications, all of the above mentioned side-effects go away on a couple of days. However, if you are experiencing an allergic reaction, you should not wait for it to disappear on its own but rather seek out emergency treatment. The treatment administered in the emergency room is going to provide immediate relief from the upsetting symptoms you have experienced due to the allergic reaction.

In conclusion, viscosupplementation can improve the symptomatology of osteoarthritis, bringing the necessary pain relief and increasing the range of motion in the affected joint. At the moment, it is applied in patients who were diagnosed with osteoarthritis of the tibio-femoral joint but further research is made to extend this conservation treatment to other joints in the body (shoulder, hip etc.). Studies are also undertaken in order to determine whether viscosupplementation would be a suitable treatment alternative for other orthopedic conditions and degenerative diseases.