Orthopedic clinics commonly see patients who have knee osteoarthritis. Doctors are here to help improve the pain that’s associated with it and prolong the knee’s ability to function so a total knee arthroplasty is unnecessary. The first step in doing so is to analyze the hyaluronic acid (HA) that’s naturally found in the synovial fluid. Here it acts as a shock absorber, helps lubricate the joints, and decreases the impact upon the knee. When analyzed, it’s oftentimes found to have a decreased molecular weight and be both thick and sticky inconsistency. These studies have led to the field of viscosupplementation which helps supplement the HA that naturally occurs in the knee. With HA injections the knee becomes lubricated and able to absorb shock once again.
HA injections range from one to five injections for a cost of $180 – $350. The HA in these injections is derived from avian and bacterial sources.
Reviews of HA Injection Treatment
Many different reviews have been published in various places regarding this treatment for knee osteoarthritis. While they do all analyze the same papers, it’s regarding different outcome measures.
American Academy of Orthopedic Surgeons reviewed osteoarthritis’ treatment options in 2013. Herein they found that HA injections of high molecular weight did best. Unfortunately, they felt that minimal clinical improvements weren’t met but this isn’t a validated measure so it shouldn’t be relied upon when making decisions. Therefore the American Society for Sports Medicine conducted their review in which they looked at patients’ benefits and in doing so they discovered they responded 15% better than they did to intra-articular joint injections.
In a 2015 meta-analysis by Arthroscopy, it was discovered that there isn’t much in the way of significant clinical improvements with intra-articular Hyalgan injections. However, it was proven that these results did last longer than corticosteroid injections. They also came to recommend HA injections over NSAIDs because they didn’t have such negative side effects.
Throughout these various studies, some other important outcomes were noted. These include:
- The Annals of Internal Medicine (2012) reported that when it came to knee pain HA injections did not offer significant improvement, not even when it came to the functioning of the knee. Unfortunately, HA’s weight wasn’t taken into consideration here.
- Different brands of HA were also analyzed to see if there was any difference in safety or efficacy. The only real difference discovered here had to do with its weight.
- Arthritis and Rheumatism (2009) discovered that the effects of HA outlast that of corticosteroids.
Understanding the Results
Most studies do indicate apparent advantages to HA with higher molecular rates. However, this can’t be used in determining which HA is superior. Nevertheless, scientists continue to search for ways in which to improve and deliver these injections. This has led to new HA formulations that offer delayed drug release and increased joint retention. Some are also combining HA with platelet-rich plasma (PRP) injections in hopes of delivering a higher growth factor concentrate. This should help repair the knee’s cartilage while the HA stabilizes its synovial fluid.
When the various reviews of HA are all considered you’ll arrive at a wide variation of opinions regarding the injections themselves. One of the main conclusions is that when you use a heavier weighing HA the outcomes are typically better. So far no review focuses on knee pain. For this reason, future studies are needed, especially ones focusing on ways to improve the delivery of these injections. In the meantime, if you’re interested in the viscosupplementation procedure contact the Genesis Medical Clinic in Tampa, FL today.
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