What Is Intraarticular Gel injections?
Osteoarthritis of the knee is one of the leading causes of disability in the United States. It develops slowly and the pain it causes worsens over time. Although there is no cure for osteoarthritis, there are many treatment options available to help people manage pain and stay active.
In its early stages, arthritis of the knee is treated with nonsurgical methods. Your doctor may recommend a range of treatments, including:
- Modifying your activities
- Weight loss
- Pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
- Physical therapy
- Corticosteroid injections
Another treatment option is a procedure called viscosupplementation. If you have tried all other nonsurgical treatment methods and your pain continues to limit your activities, viscosupplementation may be an option.
In this procedure, a gel-like fluid called hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. People with osteoarthritis have a lower-than-normal concentration of hyaluronic acid in their joints. The theory is that adding hyaluronic acid to the arthritic joint will facilitate movement and reduce pain.
Intraarticular Gel injections Overview
Depending on the product used, you will receive one to five shots over several weeks. During the procedure, if there is any swelling in your knee, your doctor may remove (aspirate) the excess fluids before injecting the hyaluronic acid. Usually, the aspiration and the injection are done using only one needle injected into the joint, Some doctors may prefer to use two separate syringes.
For the first 48 hours after the shot, you should avoid excessive activity, such as jogging or heavy lifting.
Before and After the Procedure and the Risks
Before the Procedure
You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over-the-counter medications you take, including herbal and vitamin supplements. In particular, you should temporarily stop taking for at least 10 days before the procedure date, any medication that can cause unnecessary bleeding: Aspirin, Vitamin E, arthritis medications like Advil, Ibuprofen and blood thinners like Coumadin, Plavix, Trental, etc. The doctor will tell you if and when you need to discontinue the medications.
It is very important to tell the doctor if you have asthma, had an allergic reaction (i.e. hives, itchiness, difficulty breathing, any treatment which required hospitalization) to any local anesthetic agent used in the past, such as novocaine or lidocaine. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.
After the Procedure
Icing for 15 to 20 minutes several times later on the day of the injection is recommended, along with easy range of motion exercises of the joint. You may return immediately to work or regular activities after the injection. You may drive, although some people feel less nervous if they know they have someone along to drive them home. You should continue any physical therapy sessions already scheduled. You may be sore over the treated areas for the first 24 to 48 hours. If any unusual redness or swelling or warmth occurs at the injection site, notify the physician. You may continue taking all of your regular medications. It may take a few days for the corticosteroid medication to start working and you should notice long-term pain relief starting to work by then.
The risks, although infrequent, include: Allergic reaction to the medications used; Nerve damage; Bruising or infection at the injection site. If you experience persistent pain or numbness in the area of the injection site after the normal healing period (usually 3-5 days), you should call the doctor right away.