Osteoarthritis is a joint disease that causes the cartilage to wear down over time, leading to pain and stiffness in the affected area. It is a degenerative condition.
One of the most essential areas affected by osteoarthritis is the knee joint. As the disease progresses, patients may experience reduced mobility and increased pain, significantly impacting their quality of life.
Hyaluronic acid injections, also known as viscosupplementation, have recently become a popular treatment option for knee osteoarthritis.
Hyaluronic acid is a naturally arising substance found in the synovial fluid of the joints, which acts as a lubricant and shock absorber. The theory behind hyaluronic acid injections is that injecting additional hyaluronic acid into the knee joint will help to improve lubrication and reduce inflammation, thereby reducing pain and improving mobility.
So, do hyaluronic acid injections work for knee osteoarthritis? The answer is more complex, as evidence of their efficacy must be provided.
Some studies have shown that hyaluronic acid injections can relieve short-term pain and improve function in patients with knee osteoarthritis. In contrast, other studies have found no significant benefit over placebo injections.
A thorough examination of the effectiveness of hyaluronic acid injections for knee osteoarthritis was printed in the Journal of the American Medical Association (JAMA) in 2015 through a meta-analysis.
The analysis included 89 randomised controlled trials involving over 12,000 knee osteoarthritis patients treated with hyaluronic acid or placebo injections.
The study found that while hyaluronic acid injections were linked with a statistically significant improvement in pain compared to placebo injections, the effect size was small and not considered clinically meaningful.
Another meta-analysis published in the Annals of Internal Medicine in 2015 came to similar conclusions. The analysis included 137 randomised controlled trials involving over 33,000 knee osteoarthritis patients treated with hyaluronic acid or placebo injections.
However, some individual studies have shown more promising results. A randomised controlled trial printed in the Journal of Orthopaedic Surgery and Research in 2019 found that hyaluronic acid injections were associated with significantly decreased pain and improved function in patients with knee osteoarthritis.
The study included 70 patients treated with hyaluronic acid or saline injections over six months. The authors concluded that hyaluronic acid injections may be a reliable and secure treatment option for knee osteoarthritis.
Despite the conflicting evidence, many clinicians continue to use hyaluronic acid injections as a treatment option for knee osteoarthritis, particularly for patients who have not responded to other treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs) or physical therapy. One reason may be that hyaluronic acid injections are generally considered reliable and have few side effects, making them a relatively low-risk option for patients.
The effectiveness of hyaluronic acid injections may depend on profuse factors, like the severity of the osteoarthritis, the type of hyaluronic acid used, the dosage and frequency of injections, and the patient’s response to the treatment.
Therefore, patients must discuss hyaluronic acid injections’ potential advantages and risks with their healthcare provider and consider other treatment options.
How Hyaluronic Acid Injections Work In The Osteoarthritic Knee
Hyaluronic acid injections, or viscosupplementation, are a treatment option for knee osteoarthritis. Osteoarthritis is a situation where the cartilage in the joints gradually wears down, causing stiffness and pain in the affected area.
Hyaluronic acid injections involve injecting a gel-like substance of hyaluronic acid into the knee joint to provide lubrication and reduce inflammation.
Hyaluronic acid naturally occurs in the synovial fluid of joints and serves as a lubricant and shock absorber.
In patients with knee osteoarthritis, the amount of hyaluronic acid in the synovial fluid is reduced, which can contribute to joint pain and stiffness. Hyaluronic acid injections supplement the natural hyaluronic acid in the knee joint, providing additional lubrication and cushioning to the affected area.
Injections for osteoarthritis are given in a series over a few weeks or months, depending on how critical the condition is and how the patient responds to treatment. Healthcare professionals, like orthopaedic surgeons or rheumatologists, usually administer the injections using sterile techniques.
The procedure itself is relatively straightforward and typically takes only a few minutes. The healthcare professional will clean the skin around the knee joint with an antiseptic solution and may use a local anaesthetic to numb the area.
Then, they insert a needle into the joint and inject the hyaluronic acid gel. After the injection, the healthcare professional may massage the knee joint to distribute the gel evenly.
The exact mechanism of hyaluronic acid injections work has yet to be fully understood, but it involves several factors. One of the main benefits of hyaluronic acid injections is their ability to provide additional lubrication to the knee joint.
The hyaluronic acid gel acts as a lubricant, reducing friction between the bones in the joint and allowing them to move more smoothly. Applying this method can alleviate pain and stiffness in the affected region while enhancing mobility.
Hyaluronic acid injections may also have anti-inflammatory effects, further reducing pain and swelling in the knee joint. Inflammation is a common feature of osteoarthritis, and reducing inflammation can help slow the disease’s progression and improve joint function.
Additionally, hyaluronic acid injections for knee pain may help stimulate natural hyaluronic acid production in the knee joint. By providing different hyaluronic acids to the joint, the injections may help restore the balance of hyaluronic acid in the synovial fluid, improving joint function over time.
Overall, hyaluronic acid injections are a treatment option for knee osteoarthritis that can provide short-term pain relief and improve function in some patients.
While the exact mechanism by which they work is not fully understood, they are thought to provide additional lubrication to the knee joint, reduce inflammation, and stimulate natural hyaluronic acid production.
Multiple factors can influence the effectiveness of hyaluronic acid injections. Patients should consult their healthcare provider and carefully weigh the risks and benefits before choosing a treatment plan.