Osteoarthritis of the knee is the leading cause of disability in the United States. While there is no cure for it, there are many treatment options available to help restore function and help with pain relief. Osteoarthritis is a pain that develops slowly over time, causing symptoms such as inflammation, tenderness, and stiffness.
In the early stages, arthritis of the knee is treated with conservative treatment. The following options are effective ways to improve symptoms and help control knee pain.
- Low impact activities such as elliptical, bicycle, and aquatic therapy
- Good quality, cushioned shoes
- Physical therapy to increase knee range of motion and strengthen the muscles around the knee and hip
- Compressive knee sleeve to help limit swelling and provide proprioceptive feedback
- Pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen
- Corticosteroid injections
- Over the counter solutions such as glucosamine and chondroitin
If you have tried other nonsurgical treatment options and your pain continues to limit your activities, another treatment option is a procedure called viscosupplementation.
Viscosupplementation is a therapeutic injection of gel-like fluid called hyaluronic acid, which is injected into the knee joint. It is one of the few “biologic” treatments that is covered by commercial insurance and Medicare. Hyaluronic acid is a naturally occurring substance found in the synovial joint fluid, which acts as a lubricant to enable bones to move smoothly over each other. It also helps to act as a shock absorber for joint loads. People with osteoarthritis have a lower-than normal concentration of hyaluronic acid in their joints. Viscosupplementation adds hyaluronic acid to the arthritic joint to facilitate movement and reduce pain, acting as the naturally occurring joint fluid.
Recent research shows that 70-80% of people with mild to moderate osteoarthritis will have noticeable improvement with pain. However, even if you do not have improvement in pain symptoms, the injections may help improve the health of your knee cartilage.
Viscosupplementation was first used in Europe and Asia, and was approved by the U.S Food and Drug Administration in 1997. Several preprations of hyaluronic acid are now commercially available, which include: Hyalgan, Supartz, Synvisc, Euflexxa, and Orthovisc. Viscosupplementation used to be obtained from a “rooster’s comb,” but newer versions are created in a lab.
Partially referenced from Orthoinfo