Viscosupplementation is a treatment for osteoarthritis of the knee joint that involves injecting a gel-like substance called hyaluronic acid into the affected joint. This creates a natural barrier to the rubbing and grinding from the arthritis by cushioning and lubricating the joint. These treatments are all-natural and not even considered medication by the FDA. This is the most natural intervention to treat knee arthritis available in medicine today. Viscosupplementation has been FDA-Approved since 1995 and there has been hundreds of millions of these injections performed worldwide to treat knee arthritis.

The treatment was originally discovered from treating the knees of race horses in the 1950’s and eventually evolved into a human intervention in the 1970’s overseas. The treatment eventually made its way back to the states when the first research studies were performed in the US in the early 1990’s.

Hyaluronic Acid (HA) also known as hyaluronan is a natural substance made by the synovial tissues of the joint and cartilage. HA is responsible for the viscosity of the natural lubricating fluid of the joint called synovial fluid. Without proper volume of HA in the joint, friction, pain and inflammation builds over time causing symptoms of stiffness, discomfort, aching and further joint damage. By rebuilding the lost volume and concentration of HA in the arthritic knee, we are able to manage arthritis symptoms long term with continued treatment.

• Injection: The hyaluronic acid preparations come pre-packaged in a syringe from the manufacturer and is injected under live X-Ray guidance precisely into the knee joint(s).
• Lubrication and Shock Absorption: The injected hyaluronic acid aims to supplement the joint’s natural synovial fluid, improving lubrication, and acting as a shock absorber.
• Potentially Reduces Pain and Inflammation: This enhanced cushioning and lubrication, may help reduce pain, improve joint mobility, and potentially slow the progression of osteoarthritis.
• Series: The treatments are given once per week for 3-5 weeks depending on the product covered by your insurance plan.
• Long Term Results: If the treatments are successful at relieving your pain and improving function, they can be repeated every 6 months for continued relief long term. There is no concern with long term side effects since the gel is all-natural.

• Experience and Proficiency: We have performed hundreds of thousands of joint injections for arthritis for more than 13 years.
• Extreme Accuracy: We use Guided X-Ray Imaging called fluoroscopy to visualize the joint and confirm needle placement prior to injecting the “Gel” to ensure accuracy with every procedure.
• Maximized Effectiveness: Guided imaging greatly increases the effectiveness of the treatments because we can assure that each and every injection is delivered to the source of the problem without missing.
• Minimized Risk: Real-time imaging helps avoid injecting into nearby nerves, blood vessels, or other structures that could be damaged and reduces the risk of adverse events like pain, inflammation and post procedure pain.

Compared to “Blind” Injections

• Traditional “blind” injections rely on the doctor’s knowledge of anatomy and feel for landmarks to guide the needle.
• Blind injections, although sometimes effective, have a much higher margin of error in terms of medication placement.

• Most patients tolerate the treatment very well with little to no pain or discomfort. We have performed hundreds of thousands of these treatments for more than a decade so our providers are extremely proficient.
• Occasionally patients can expect to have some pain during the procedure depending on how bad they are hurting or if their joint is sensitive due to the inflammation. This discomfort typically resolves within a few seconds.
• The skin over the injection site is numbed with a “Cold Spray” prior to the injection and we also use a local anesthetic to numb the joint tissue.
• Rarely do patients have any side effects from the treatment, but a very small percentage have some additional pain/discomfort for a few days after the treatment.

Viscosupplementation might be an option if:

• Osteoarthritis diagnosis: You osteoarthritis of the knee joint.
• Other Treatments Haven’t Helped: Conservative treatments like medication, physical therapy, and lifestyle changes haven’t provided adequate relief.
• Delaying Surgery: You want to try a less invasive option before considering surgery.

• Yes, viscosupplementation is covered by most major insurances plans including Medicare as long as you meet the requirements.