Viscosupplementation for Osteoarthritis

What is Viscosupplementation for Osteoarthritis

Viscosupplementation is a medical procedure involving the injection of hyaluronic acid into a joint.

Hyaluronic acid is a gel-like fluid that occurs naturally in the synovial fluid. It surrounds the joints, helping reduce friction during movement. Injections of this acid can help lubricate the joint and improve the synovial fluid’s cushioning ability, enhancing the mobility and functionality of the affected joint.

This is commonly used to treat osteoarthritis, commonly in the knee. Osteoarthritis is a degenerative joint disease that predominantly affects middle-aged and older adults. It leads to the deterioration of joint cartilage and the adjacent bone in the knees​​.

Indications for Viscosupplementation

Viscosupplementation is primarily considered for certain patient groups and conditions, which may include the following:

Mild to Moderate Osteoarthritis

The procedure is particularly beneficial for individuals experiencing mild to moderate osteoarthritis. It offers a non-surgical option for managing joint pain and can be an interim solution for those seeking to postpone surgery. The effectiveness of viscosupplementation tends to diminish as osteoarthritis progresses, making it less suitable for advanced stages of the disease.

Other Types of Arthritis

Besides osteoarthritis, this treatment may be considered for individuals with different types of arthritis, such as rheumatoid arthritis. The suitability of this procedure for each specific arthritis type can be determined upon professional medical consultation.

Preparing for Viscosupplementation

Before undergoing viscosupplementation, certain preparatory steps are generally taken:

• Medical Consultation
  A thorough evaluation of the patient’s condition, including their overall health status, can help assess the individual suitability of the procedure.
• Review of Medical History
  This includes evaluating any past treatments for arthritis and considering any potential allergies or conditions that might affect the procedure’s safety.
• Physical Examination
  A detailed examination of the affected joint is conducted to determine its current state and to decide on the location and intensity of the injection.

Viscosupplementation Procedure

The viscosupplementation procedure is a quick and straightforward process, which typically involves the following steps:

1. Preparing the Area Around the Joint: The area around the joint is cleaned with antiseptics to reduce the risk of infection.
2. Administration of Anaesthesia: To minimise discomfort, local anaesthetic is administered around the joint area.
3. Fluid Aspiration: If there is excess fluid in the joint, it will be aspirated before the injection of hyaluronic acid.
4. Hyaluronic Acid Injection: Hyaluronic acid is injected into the joint space using a syringe attached to a needle.
5. Post-Injection Care: A small bandage is applied to the injection site following the procedure.

Recovery and Rehabilitation

The recovery and rehabilitation process after viscosupplementation usually involves the following:

• Pain Management
  During the initial recovery period, some discomfort may be experienced in the joint area. This pain can typically be managed with over-the-counter pain relievers, as suggested by the osteoarthritis specialist.
• Rest and Activity Modification
  Initial rest is recommended, followed by a gradual return to activities. Avoiding high-impact exercises initially is important to prevent undue stress on the treated joint.
• Monitoring for Side Effects
  Monitor for any signs of infection, allergic reactions, or other complications. Any concerns should be notified promptly to prevent complications.
• Gradual Resumption of Activities
  Patients should gradually resume their normal activities, starting with walking and other low-impact exercises, to aid in joint mobility and recovery.
• Regular Follow-up Appointments
  Regular check-ups should be conducted to help monitor the joint’s response to the treatment and address any ongoing concerns.

Risks and Complications

Viscosupplementation, like any medical procedure, carries certain risks and potential complications.

• Pain at Injection Site: The most common issue is pain or discomfort at the site of the injection, which is usually temporary.
• Bleeding and Infection: There is a small risk of bleeding and infection at the injection site. Patients should watch for signs of infection and seek medical attention if necessary.
• Allergic Reactions: Though rare, allergic reactions to the components of the injected material can occur.
• Limited Efficacy in Advanced Stages: In later stages of osteoarthritis, viscosupplementation may be less effective, and other pain management strategies may be necessary.