What is joint fluid?
Normal healthy joints create synovial fluid, which is a thick substance that helps protect the structures within joints and allows for smooth and painless movement. When there is damage to some of the tissue in a joint, it loses the ability to create Hyaluronic acid, which is a large component of joint fluid. With continued use of the joints, further wear and tear results in pain, stiffness, inflammation, and deterioration of the tissue surfaces within it.
What is Viscosupplementation?
Viscosupplementation refers to the process of repleting Hyaluronic acid in joints by injecting it. There are several different brands of artificial Hyaluronic acid, including Euflexxa, Hyalgan, Supartz, and Synvisc. At this time, viscosupplementation is only FDA approved for osteoarthritis of the knee, although it has been used in other joints of the body.
How is the procedure performed?
The artificial Hyaluronic acid is delivered into the joint by a series of injections- usually between 3 to 5, ideally 1 week apart. We perform all of our joint injections in the office using ultrasound guidance, which ensures accurate needle placement into the joint space. In the knee, there are many structures in close proximity- the quadriceps tendon, suprapatellar fat pad, joint space, and the prefemoral fat pad. At times, these stuctures are within millimeters of each other.