Common Knee Problems :: Hyaluronate Injections for Arthritis
Knee pain, due to arthritis, affects millions of Americans every year. Arthritis of the knee primarily affects seniors, although there are a large number of individuals in their 40's and 50's who develop arthritis, usually following an earlier injury. A number of treatment options exist for the treatment of arthritis, both surgical and non-surical. Nonsurgical treatment is the initial choice for nearly all patients, and includes use of a cane or crutch, knee bracing, or anti-inflammatory medications, such as ibuprofen. Additional medications such as acetaminophen (Tylenol), glucosamine and chondroitin sulfate may help control pain. Surgical options include knee arthroscopy and total knee replacement.In 1997, the Federal Food and Drug Administration approved a new treatment for knee arthritis called hyaluronate injections, also referred to as "viscosupplementation." Hyaluronate is a substance normally found in joint cartilage. It is isolated from rooster combs and injected into the arthritic knee, in a series of 3 to 5 injections. It is promoted as having a protective function for joint cartilage and possibly a reparative function as well, although much of this information is speculative, because its exact mechanism of action is unknown. There is no substantiated evidence of any protective effect of hyaluronate injections on joint cartilage or that it will alter the progression of a knee with arthritis.
It is primarily intended for mild to moderate knee arthritis, but may provide long-term benefit in patients over 60 with advanced arthritis. It has been referred to as "liquid joint replacement", but that does not truly describe its function. A number of studies have looked at its use in patients in the United States, Canada and Europe. When examined closely, the hyaluronate injections are as effective as use of anti-inflammatory agents or acetaminophen. Some studies have found them no more effective than simply removing the fluid from the joint with a needle. Hyaluronate injections appear to offer relief of pain for some patients, although the exact length of the relief is unknown. Joint aspiration, saline injections, anti-inflammatory medications and acetaminophen may be equally effective.
Hyaluronate injection is relatively noninvasive and does not "burn any bridges" for future treatment. It remains another tool in the treatment of knee arthritis, however, the disease remains an elusive problem that does not, as yet, have a perfect solution.
For more information on Hyaluronate injections or treatment of knee arthritis please contact your physician or health care provider.
