Viscosupplementation or “Gel” Injections
Knee pain due to osteoarthritis affects everyone differently. Some people have minimal pain while others have intense, debilitating pain. When the cartilage that protects the ends of the bones deteriorates, the shock-absorbing joint fluid does not work as well and our bones may begin to rub against each other, causing pain. You may find that you are not able to exercise comfortably or your knee pain may inhibit your daily activities. While there is no cure for osteoarthritis, adding some lubrication fluid may help alleviate some of your symptoms so you can return to your normal activity with less pain.
Hyaluronic acid exists naturally in the synovial or joint fluid in our joints. As we get older, the hyaluronic acid begins to break down therefore limiting the fluidity of your joint motion. Decreased hyaluronic acid combined with deterioration of the cartilage causes pain and decreased function.
Viscosupplementation or “Gel” injections replace the missing hyaluronic acid. The gel will lubricate and cushion your knee during movement, alleviating some or all your arthritis pain.
Frequently Asked Questions:
When should I start thinking about using gel injections?
If you have tried several conservative therapies such as dietary changes, exercise, and over-the-counter anti-inflammatory pain medication such asibuprofen or naproxen but are still struggling with your arthritis pain, you may consider trying a gel injection.
How long will the gel last?
Each brand of viscosupplementation has different protocols for how many injections you need and how long the results will last. Most brands can provide up to six months of pain relief.
How do the different brands of viscosupplements differ
There are several brands of viscosupplements, but essentially, they are all very similar. Their differences are mainly in the number of injections and how long the effects last.
How is the injection given?
The gel isinjected directly into your knee joint. Oftentimes, we will use some medication to numb your knee and we may utilize ultrasound guidance to assist the procedure.
How many injections are there?
It depends on the brand. There may be one, two or three injections that are spread out over two or three weeks.
How quickly does the gel start working?
Typically, people will start to notice symptom relief within in a week, but it can take a month before you notice full effect.
What is the gel made of?
The main substance is called hyaluronan that comes from chicken combs. Let your doctor know if you are allergic to products from birds such as feathers, eggs, or poultry.
What should I expect after an injection?
You should be able to return to normal daily activities but avoid excessive strain on your knee such as jogging, heavy lifting or prolonged sitting. You can take acetaminophen or ibuprofenand apply ice to your knee as needed following an injection.
What are the risks of having a gel injection?
The risks are very minimal. Some patients will experience an inflammatory response or reaction at the point of injection. They may also experience pain and discomfort during the injection. Of course, there is always the risk of infection, but this risk is very minimal.
Are there side effects?
The most common side effects are pain, swelling, stiffness, warmth, redness and/or fluid on the knee. The side effects are generally mild and do not last long.
How many injections can I have in my lifetime?
There is no limit in the number of injections, but they can lose their efficacy over time as your arthritis worsens.
Is viscosupplementation an alternative treatment for people looking to avoid surgery?
For people with severe arthritis, gel injections are not a substitute for total knee replacement. Surgery is an important treatment option for severe knee arthritis when other treatment options have not proven successful. A knee replacement is extremely effective whenknee arthritis becomes severe and fairly advanced.
Is viscosupplementation covered by insurance?
Our staff will get insurance approval for the injection, but the injections are typically covered if not performed within six months of each other. You can always check your plan to see your specific coverage.If the injections are not a covered benefit, out-of-pocket cost can range from $100-$800 for the medication with an additional fee for the procedure itself.