UMEM Educational Pearls

Category: Orthopedics

Title: Viscosupplementation

Keywords: Knee OA, injection (PubMed Search)

Posted: 9/9/2017 by Brian Corwell, MD (Updated: 9/26/2017)
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Viscosupplementation

Hyaluronic acid (HA) is a high-molecular weight polysaccharide

A major component of synovial fluid and of cartilage

Major role of HA is as a lubricant, shock absorption, antinociceptive effect

               Used in veterinary medicine for decades

Multiple brands exist with differences based on the molecular weight and how they are produced

Use supported by the Cochrane database (2007, 2014) for knee OA

Post injection strength gains are due to pain relief

May have a role for those who cannot receive steroid injections

Inject in similar manner to intra articular steroids

Caution in those with known allergy to poultry /eggs

Risks: Local reaction (likely from preservative), injection site pain, infection, bleeding.