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Viscosupplementation May Provide Relief Without Surgery to Painful Knees.

January 10, 2018

What is Viscosupplementation?

  • Viscosupplementation is a non-surgical medical treatment for degenerative or osteoarthritis of the knees. It involves using a small needle to inject medication into the knee joints to lubricate the degenerative joint. The medication injected into the joint is called hyaluronic acid.
  • Hyaluronic acid occurs normally in the joints but the concentration decreases as the joints degenerate. The goal of replacing this compound in the joint is to decrease friction, improve motion of the joint, reduce pain, and hopefully delay or prevent the need for surgery on the joint.
  • Degenerative and painful knee joints often decrease one's ability to participate in exercise or rehab of the knee. By decreasing the pain associated with osteoarthritis of the knee, many people are able to engage in activities that strengthen the muscles around the knee and improve range of motion. Such increased physical activities have significant benefits, not only to the knee joints but to the entire body. Improved activity levels and overall health also can significantly improve individuals’ quality-of-life and overall sense of well-being.
  • Viscosupplementation injections are outpatient procedures usually performed in your physician's office, often with the use of ultrasound or fluoroscopy (x-ray) guidance for precision placement of the medication. They require only local anesthetic and usually only take a few minutes to complete. The usual injection contains only 2 mL of hyaluronic acid. This is about half the volume of a normal knee joint’s fluid. Often, the amount of joint fluid in a degenerative knee decreases as time goes by. However, even if the volume of fluid is normal, the concentration of hyaluronic acid in the degenerative joint’s fluid is significantly lower than that of a healthy joint. The additional fluid and thickness (viscosity) provided by the added hyaluronic acid in the degenerative joint helps to act as a cushion or padding during activities.
  • By improving the padding and lubrication in the joint, the goal is to improve function and hopefully slow down the degenerative process in the joint.

 

 Is this treatment FDA approved?

Currently in the United States, using hyaluronic acid business supplementation is only approved by the FDA to treat degenerative knee joints. Some physicians have injected hyaluronic acid into other joints such as shoulders and hips. While this is allowed by the FDA, it is considered "off-label" and is usually not covered by most insurance companies.

Is this treatment covered by insurance companies?

Most insurance companies do cover the FDA approved injection of hyaluronic acid into degenerative knee joints as long as their medical policy requirements are met.

Is this treatment a permanent solution?

In most cases, viscosupplementation is not a permanent solution. However, for many individuals, this treatment can give many months or years of improved function and decrease pain. Additionally, it can frequently delay surgery for extended periods of time. With improved function, many people are hoping the delay of surgery will allow them to have more options available as treatment technology improves for degenerative joints.

About the Author
Dr. John B. Adams is board certified in Pain Management by the American Board of Medical Specialties and the American Board of Interventional Pain Physicians. With almost 2 decades of experience, he offers patients access to state-of-the-art pain management, emphasizing a multidisciplinary approach to pain management utilizing precision injections, neuromodulation technology, physical therapy, behavioral medicine and judicious use of medications including help with patients titrating off opiates (narcotic pain medications).

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