Hyaluronic acid injection for knee arthritis

WHAT IS HYALURONIC ACID?

Hyaluronic acid is a gel-like mixture that is made up of hylan A fluid, hylan B gel, and salt water. Hylan A and hylan B are made from a substance called hyaluronan. The human body also makes its own hyaluronan. Hyaluronan is present in very high amounts in joints. The body’s own hyaluronan acts like a lubricant and a shock absorber in the joint and is needed for the joint to work properly

WHAT ARE HYALURONIC ACID INJECTIONS USED FOR?
Hyaluronic acid injections are used to relieve knee pain due to osteoarthritis. Osteoarthritis is a type of arthritis that involves the wearing down of cartilage (the protective covering on the ends of your bones).  These injections are used for patients who do not get relief from physical therapy, or relief from simple painkillers such as acetaminophen, or non-steroidal anti-inflammatories such as ibuprofen.  In osteoarthritis, there may not be enough hyaluronan, and/or there may be a decrease in the quality of the hyaluronan in the joint.

WHAT OTHER TREATMENTS ARE AVAILABLE FOR OSTEOARTHRITIS?
If you have osteoarthritis, there are other things you can do besides getting Hyaluronic acid injections, these include:

NON-DRUG TREATMENTS:

  • avoiding activities that cause knee pain
  • exercise
  • physical therapy
  • removal of excess fluid from your knee
  • arthroscopic surgery

DRUG THERAPY

  • pain relievers such as acetaminophen and narcotics
  • drugs that reduce inflammation (signs of inflammation are swelling, pain or redness), such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
  • steroids that are injected directly into your knee (such as cortisone)

HOW IS SYNVISC AND HYALURONIC ACID GIVEN?
The doctor will inject 2 mL of Synvisc or a similar substance made by a different manufacturer (Orthovisc, Eufflexa, Hyalgan) into your knee once a week, for three weeks (a series of three injections in total).

ARE THERE ANY REASONS WHY YOU SHOULD NOT RECEIVE SYNVISC INJECTIONS?

  • You should not be given Synvisc or similar injections if you have an allergic reaction to Synvisc or hyaluronan products
  • You should not be given these type of injections if you have a knee joint infection, skin diseases, or infections around the area where the injection will be given

THINGS YOU SHOULD NOW ABOUT SYNVISC AND HYALURONIC ACID INJECTIONS:

  • Synvisc and other types of hyaluronic acid injections are currently only FDA approved for the knee, and is performed only by a doctor or other qualified health care professional
  • Tell your doctor if you are allergic to products from birds, such as feathers, eggs and poultry
  • After you receive the injection, you may need to avoid activities such as jogging, tennis, heavy lifting, or standing for long periods of time for the first day or two after an injection.
  • Hyaluronic acid has not been tested in pregnant women or women who are nursing. You should tell your doctor is you think you are pregnant, or if you are nursing a child.
  • The safety and effectiveness of Synvisc and similar hyaluronic acid injections have not been tested in children.

POSSIBLE SIDE EFFECTS:

  • Pain, swelling, heat, or redness around the injection site
  • Fluid build-up around the knee
  • Rare cases of knee joint infection have been reported
  • Rare cases of rashes, hives and itching have been reported
  • Less common side effects: muscle pain/cramps, flushing or swelling of your face, fast heartbeat, nausea, dizziness, fever, chills, headache, difficulty breathing, swelling in your arms or legs, prickly feeling of your skin, low number of blood platelets

HOW LONG WILL THE INJECTION LAST?
The injections often give pain relief for anywhere between three and six months, and sometimes longer. Notably, there is a chance that the injections will not help.
If the injections help for a period of time, however the pain returns, the series of injections can be repeated.

HOW CAN I GET MORE INFORMATION ABOUT SYNVISC, OTHER TYPES OF HYALURONIC ACID INJECTIONS, AND ABOUT OSTEOARTHRITIS?
For more information about Synvisc, you can call Genzyme Biosurgery at 1-888-3SYNVISC. You may also visit the Genzyme Biosurgery website at www.synvisc.com.

For more information about Eufflexxa, Orthovisc, or Hyalgen, you can visit their respective websites:

Euflexxa: www.euflexxa.com

Orthovisc: www.orthovisc.com

Hyalgan:  www.hyalgan.com

For more information about osteoarthritis, you can visit www.orthoinfo.org. or speak with Dr. Stetson about what options might be best for your knee.  You can find more information on his website at www.sportsmedicinedr.com and at www.stetsonpowell.com.

If you would like to proceed with these injections, please contact Dr. Stetson’s medical assistant, Suzie, at (818) 848-3030 or you can email her at Suzie@stetsonpowell.com.  We will then contact your insurance company and, if approved, we will contact you to schedule your appointment to start the injections.

Click here to download this information as a PDF: Synvisc and Hyaluronic Acid