Home Featured Discussion Osteoarthritis Viscosupplementation

Viscosupplementation

One of the newer treatments for osteoarthritis of the knee is viscosupplementation, the injection of hyaluronic acid into the knee. Hyaluronic acid is naturally found in joint fluid, it acts as part of the lubrication system of the joint. In people with osteoarthritis, the quality and quantity of hyaluronate in the joint fluid and tissues may be deficient. 

Usually given when standard medication and exercise programs fail to relieve pain in a series of joint injections, 3 or 5 depending on the brand used. Currently only used in the knee, studies are underway to evaluate the product in osteoarthritis of the hip and shoulder.

Study results seem to vary greatly. One study done at the University Hospital in Lund, Sweden concluded that patients older than 60 years with knee osteoarthritis and with significant symptoms, comprise the group most likely to benefit from treatment with intra-articular hyaluronan injections. While another study done in London concluded preparation of 750 kD hyaluronan offers no significant benefit over placebo during a five week treatment period. Still another found it to be more effective than Naproxen for knee OA.

So what are the people saying? Depends on who you ask. In a very unscientific survey I've found that about 50% of those that have had the injections found them beneficial. However I have no information about the degree of severity or their individual medical history, so your mileage may vary significantly. 

We've added the two brands found in the US to our medication index, Synvisc and Hyalgan. Do your research and ask your doctor if it may be right for you.


References:
Intra-articular hyaluronan injections in the treatment of osteoarthritis of the knee: a randomised, double blind, placebo controlled multicentre trial. Hyaluronan Multicentre 
Lohmander LS - Ann Rheum Dis - 1996 Jul; 55(7): 424-31 
Intra-articular injections of 750 kD hyaluronan in the treatment of osteoarthritis: a randomised single centre double-blind placebo-controlled trial of 91 patients demonstrating lack of efficacy. 
Henderson EB - Ann Rheum Dis - 1994 Aug; 53(8): 529-34
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Tina J. Underwood
Page last updated on April 27, 2000