Viscosupplementation and Post-traumatic Osteoarthritis
Neck & Back Injuries | Post-traumatic Osteoarthritis
By Jacob W. Gent
November 4, 2011
One of the first steps in the treatment of any traumatic injury is pain management. A relatively effective approach to the treatment post-traumatic osteoarthritis following joint injuries, especially knee joints, is viscosupplementation. Pain relievers, like ibuprofen or nonsteroidal anti-inflammatory drugs (NSAIDs) are normally used along with physical therapy, topical analgesics, or even corticosteroid injections in such cases. Unfortunately, some patients react adversely to NSAIDs and these agents typically provide only temporary relief.
The procedure involves injecting a solution of hyaluronic acid into the joint where it acts as a lubricant to allow bones to move smoothly over each other and as a shock absorber for joint loads.
Hyaluronic acid does not have an immediate pain-relieving effect. Patients may notice a local reaction, such as pain, warmth, or mild swelling immediately following the injection. These symptoms generally do not last long and icing usually reduces them. Patients should avoid jogging, heavy lifting, excessive weightbearing or standing for long periods for the first 48 hours following the injection.
Longer Term Effects:
Over the course of the injections, patients notice decreased pain as hyaluronic acid seems to have anti-inflammatory and pain-relieving properties. The injections may also stimulate the body to produce more of its own hyaluronic acid. These effects may last several months.
Any swelling due to excess fluid (effusion) in the knee will be removed (aspirated) prior to injection of the hyaluronic acid. This is usually done at the same time, with only one needle injected into the joint, although some doctors may prefer to use two separate syringes. Depending on the product used, 3 to 5 injections will be administered over several weeks.
Viscosupplementation may be helpful for people who do not respond to basic treatments. It is most effective if the arthritis is in its early stages (mild to moderate). Some patients may feel pain at the injection site, and occasionally the injections result in increased swelling. The long term effects of viscosupplementation is not yet known, and research is in this area is ongoing.