Viscosupplementation
Viscosupplementation is an intra‐articular injection technique applied globally in orthopaedic practice to manage osteoarthritis (OA) in joints. Hyaluronic acid (HA) exerts a mechanical effect by providing lubrication of the joint and inhibits pain and inflammation. It also reduces programmed cell death in osteoarthritic cartilage. These benefits have made HA a commonly adopted bioactive molecule for intra‐articular therapy.
Viscosupplementation is injection therapy for osteoarthritis. It involves the injection of a lubricating fluid called hyaluronic acid into the joints. It is primarily used to alleviate the symptoms of osteoarthritis.
Viscosupplementation mainly targets osteoarthritis, a degenerative joint disease characterized by the breakdown of cartilage, leading to joint pain and reduced mobility. The rationale behind viscosupplementation lies in the properties of hyaluronic acid, a naturally occurring sugar substance found in the fluids in the eyes and joints. Hyaluronic acid is a powerful bioactive molecule.
In healthy joints, HA acts as a shock absorber and lubricant, allowing smooth joint movement. However, in osteoarthritic joints, the concentration and quality of HA decrease, contributing to joint pain and inflammation.
Viscosupplementation involves injecting a concentrated solution of high molecular weight HA directly into the affected joint to restore the lubricating synovial fluid and cushion the joint. The HA supplements the natural lubrication within the joint, reducing friction, dampening mechanical forces, and providing pain relief. Additionally, HA may have anti-inflammatory properties, further contributing to pain reduction.
Viscosupplementation is primarily indicated for the management of knee osteoarthritis, although it has also been used in other joints such as the hip and shoulder. Viscosupplementation is typically considered when conservative treatments, such as physical therapy and oral analgesics, have failed to provide adequate relief.
The ideal candidate for viscosupplementation is typically a patient with mild to moderate osteoarthritis, characterized by joint pain, stiffness, and limited mobility. It is important to note that viscosupplementation is not a cure for osteoarthritis but rather a means of symptom management.
Hyaluronic acid is biocompatible, biodegradable, and non-toxic. A 2021 Review found that viscosupplementation effectively reduces pain, increases functionality, and delays surgery in the knee to treat osteoarthritis. Because it reduces friction it helps protect the cartilage in the affected joints and reduces inflammation.
Several factors can influence the outcomes of viscosupplementation, including the type of HA used, the stage of osteoarthritis, and the patient’s individual response. Hyper Regen Sports Medicine doctors carefully assess each patient and tailor the treatment accordingly.
The viscosupplementation procedure is relatively straightforward and minimally invasive. It is typically performed in an outpatient setting and does not require anesthesia. The patient’s skin over the affected joint is cleaned and sterilized. Then a fine needle is inserted into the joint space, and the HA solution is slowly injected. After the injection, the patient may be advised to avoid strenuous activities for a brief period to allow the HA to settle within the joint.
As with any medical procedure, there are potential risks and side effects associated with viscosupplementation. These may include pain at the injection site, swelling, and transient joint discomfort. Serious complications are rare but can include infection or an allergic reaction to the HA product used.
Schedule an appointment for regenerative medicine
In conclusion, viscosupplementation is a valuable therapeutic option for individuals suffering from osteoarthritis-related joint pain and stiffness. While its effectiveness can vary from patient to patient, it remains a valuable tool in the arsenal of treatments available to manage this debilitating condition.
At a Glance
Dr. Jas Chahal
- Head of Orthopaedic Surgery, Women’s College Hospital
- Team Physician Toronto FC and University of Toronto Varsity Blues
- Associate Professor, University of Toronto Orthopaedic Sports Medicine Program
- Has more than 100 peer-reviewed publications
- Learn more
