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The use of hyaluronic acid injection to treat knee osteoarthritis is controversial. Some researchers think that the dangers associated with such treatment outweigh the potential benefits.

Arthritis affects millions of people around the world. The problem is particularly common among older people. With the rapidly aging population in the developed countries, arthritis and associated healthcare costs are becoming an important social and medical issue. In the US alone, 21 million people are suffering from the disease.

Osteoarthritis of the knee is a common problems encountered by patients. One of the currently used medical procedures to address this problem is viscosupplementation – injection of hyaluronic acid into the affected joint.

The usage of hyaluronic acid injection is based on the belief that this compound reinforces the integrity of the joints affected by knee osteoarthritis.

The production of hyaluronic acid around the joints is one of the natural occurrences in the body. With osteoarthritis, it thins out in the affected joints and its amount needs to be increased. Hyaluronic acid’s role is to provide enough lubrication to keep joint lines smooth for better function. It helps the bones in dampening shock impulse during the weight-bearing activities. 

Viscosupplementation is technically a simple procedure

The procedure commences similar to other injections. The area to be supplemented with hyaluronic acid is initially cleaned and may be injected with pain reliever if swollen. The excess fluid that caused the swelling will then be extracted by inserting a needle into the knee joint. The hyaluronic acid will then be injected through the same needle. Some patients may only require one injection while others may need 3-5 shots.

Pain reduction and better knee function is often achieved

Injections are usually given to patients who suffer from arthritic pain. It is indicated to those who have sought conservative treatments like taking pain relievers as well as hot or cold compresses but to no avail. 

Patients who can’t be given pain-relieving drugs or can’t undergo knee surgery may opt for this treatment.

The pain usually subsides in the next day or two after injection, and patients can resume their normal daily activities. However, some weight bearing activities may have to be avoided. Depending on how severe the knee osteoarthritis is, the activities like jogging and competitive sports like tennis may be avoided. Some patients may even be advised not to be on their feet for long periods.

There is a plentiful scientific literature analyzing the efficacy of hyaluronic acid injections. Recent systematic review compared the results of 29 published studies. The studies involved a total of 4,866 participants, 2,673 of which were subjected to intra-articular hyaluronic acid injection (IAHA) and 2,193 to sham saline injections. Significant positive effects resulted from IAHA injection that proved its effectiveness and safety. Improvement of function and alleviation of pain was seen between 4 and 26 weeks following the procedure in the majority of participants.

Continue reading after recommendations

  • Bellamy N, Campbell J et al. (2006) Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006 (2), CD005321
  • Ostałowska AB, Nowak D et al. (2013) Assessment of knee function and biochemical parameters of articular fluid and peripheral blood in gonarthrosis patients following intra-articular administration of hyaluronic acid. Pol Orthop Traumatol. 78, 173-81
  • Miller LE, Block JE (2013) US-Approved Intra-Articular Hyaluronic Acid Injections are Safe and Effective in Patients with Knee Osteoarthritis: Systematic Review and Meta-Analysis of Randomized, Saline-Controlled Trials. Clin Med Insights Arthritis Musculoskelet Disord. 6, 57-63
  • Rutjes, AW, Jüni, P, da Costa, BR, Trelle, S, Nüesch, E, Reichenbach, S (2012) Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. Annals of internal medicine 157 (3): 180–91.
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