When osteoarthritis afflicts the knee, you’ll typically experience pain — and often swelling and stiffness as well. The condition is caused by the wearing away of cartilage, the natural cushioning where bones meet. You can think of cartilage as a joint’s shock absorber and without this buffer, bone rubs on bone. Osteoarthritis is the most common form of arthritis, and it affects the knees most often.
While there is no cure for osteoarthritis, there are various ways to treat the symptoms, including physical therapy, over-the-counter medications, and weight loss. When those more conservative treatments fail to achieve adequate relief, patients may try viscosupplementation, which has been shown to be highly effective for alleviating the discomfort of knee osteoarthritis.
Viscosupplementation involves injecting hyaluronic acid (also known as hyaluronan or hyaluronate) into the knee to improve lubrication, allowing the joint to move with less friction. Hyaluronic acid is a gel-like substance that occurs naturally in the body. It is found in high concentrations in the joints and particularly in the cartilage and synovial fluid — the viscous liquid that lubricates the joints. That’s where the “visco” in “viscosupplementation” comes from. As we age, the amount of hyaluronic acid the body produces decreases. However, it’s easy and safe to add it back to the knee through viscosupplements.
One viscosupplement called Cingal, which is not yet approved for use in the U.S., both relieves pain and reduces inflammation by combining a viscosupplement and a fast-acting steroid.
What to Expect
Your healthcare provider may first numb the knee area with an anesthetic and possibly drain any fluid that is causing the joint to swell. The viscosupplement is then injected directly into the synovial fluid in the knee.
You should be able to go home shortly following your outpatient procedure. For the next few days, it is recommended that you go easy on your knees: avoid doing too much standing or walking, for example. You may experience some temporary pain, warmth, redness, and/or swelling after the procedure. The treatment is more effective in some people than in others. Don’t fret if you don’t experience immediate relief. It often takes several weeks to notice a difference. Some patients report relief lasts for more than six months after the injections.
Viscosupplementation seems to be most effective for people with mild or moderate osteoarthritis and one study showed that patients who were treated with viscosupplementation were able to delay knee replacement by, on average, 1.4 years if they had one injection and by 3.6 years, on average, if they had five more injections over time.