Viscosupplementation and other intraarticular injections
When osteoarthritis reaches the level where oral medications have only limited success intraarticular injection may bring good result for patients. The two major categories of drugs commonly used for intraarticular injections are the steroids and the visco-supplementary drugs.
In osteoarthritis pain is induced by many factors, but the inflammatory cytokines within the joint and the joint fluid itself sustain a vicious circle that has to be broken to bring pain relief. Steroids are well known for their strong anti inflammatory effect, nevertheless, the side effects are serious therefore even locally administered steroids must be avoided if possible. Steroid depot preparation mustn’t be administered to joints regularly. It is recommended that steroid injections be given maximum 2-3 times a year. Main side effects after the steroid injection are impaired glucose tolerance, increased blood pressure and compromised immune status.
Intensive research has been conducted in the last decades to come up with a practical option to intraarticular steroid injections. Viscosupplements offer “oil to the hinge”, and in addition to the lowered friction, it also has a strong anti inflammatory effect. Hyaluronic acid derivates are extracted from rooster comb or bacterial fermentation. As an alternative to steroid injections viscosupplementation has no significant side effects, it can be repeated 3-5 times with a week interval, and it exerts its full effect a few weeks after the completion of the treatment.
All intraarticular injections must be performed under sterile circumstances, hence orthopedic specialist’s advice and help is recommended.
