Viscosupplementation
What is Viscosupplementation?
Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication. It allows the smooth movement of the cartilage-covered articulating surfaces of the joint.
Indications for Viscosupplementation
Viscosupplementation, or hyalluronic acid, is an FDA approved treatment for osteoarthritis of the knee.
It is not FDA approved, or covered by insurance, for treatment of arthritis in any other joint or part of the body.
It is intended to treat knee arthritis which has not responded to other non-operative treatment options such as anti-inflammatories and steroid injections. Some patients, such as those with diabetes, are not candidates for steroid injections, so viscosupplementation is an excellent option.
Viscosupplementation Procedure
The viscosupplementation injection is injected directly into the knee joint to replenish the diminished synovial fluid, thereby enhancing its lubricating properties. There are several commercially available brands of viscosupplementation. These injections are covered under insurance, and your insurance company dictates which brand of injection you get. Some common brands include but are not limited to: synvisc, synvisc one, monovisc, gelsyn, genvisc, orthovisc, monovisc. These injections are done in the office, using ultrasound guidance to ensure accurate and precise placement of the injection into the knee joint. Normally, this consists of a series of three injections, with one injection provided each week for three consecutive weeks. However, there are single injections which can be provided as well.
How does Viscosupplementation Work?
The injected preparation not only supplements the hyaluronan in the joint but also stimulates the production of new hyaluronan. You will experience gradual symptomatic relief over the course of the injections which can last for several months.
Post-procedural Care Following Viscosupplementation
Ice packs and an analgesic may be used, if required, to ease any discomfort experienced after the injection. Any strenuous activity such as jogging or sports should be completely avoided for 48 hours to a week after the injection and should be resumed only after consultation with your doctor.
Risks and Complications of Viscosupplementation
You may experience mild pain, swelling, warmth, and redness at the injection site for up to 48 hours following the procedure. Headache and joint stiffness may also occur in some cases.
Immediately consult your doctor if you develop fever, or the pain and swelling fail to resolve after 48 hours following the injection.
