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Exploring the Efficacy of an Orthovisc Injection in Knee Joint Pain Management

Knee Treatments

2023-07-19

Last Updated On: 2024-01-12

Experience effective knee pain relief with Orthovisc injections. Learn about its benefits, considerations, and treatment efficacy in managing joint discomfort.

Doctor Medica team

You know how they say, once you hit your 30s, your knees start giving you problems. But the truth is knee osteoarthritis, often considered an ailment of the elderly, can affect individuals as young as their 20s. The common ways to treat osteoarthritis include exercise and physical therapy in combination with pain relief medication, opioids, or steroid injections. If the pain persists, surgery or even a knee replacement may be required.

Luckily, in the last two decades, we have been able to avoid surgery with the help of Orthovisc injections. In this article, we will delve into the effectiveness and downsides of Orthovisc, shedding light on its role in managing knee pain and improving joint function.

What Is Orthovisc?

Orthovisc is a type of injectable treatment known as a viscosupplementation. It is composed of a high molecular weight form of hyaluronic acid, also known as hyaluronan, a substance naturally found in the body’s joints and synovial fluid. Hyaluronic acid replaces lost synovial fluid and acts as a lubricant and shock absorber, helping to cushion the joints and reduce friction during movement. 

Orthovisc treatment gained full FDA approval in 2004 and has since emerged as a promising treatment modality for osteoarthritis. This non-surgical approach offers a targeted and minimally invasive option for patients experiencing joint pain and inflammation. It is typically administered before knee surgery after the patients have exhausted more conventional treatments like physical therapy and exercise. 

The procedure typically involves one injection per week for three to four weeks and offers relief for up to six months. After the initial effect wears off, the treatment can be repeated as often as necessary. 

How Does Orthovisc Work?

Osteoarthritis is a degenerative joint disease that occurs when the protective cartilage that cushions the ends of the bones wears down over time. This can happen due to various factors, including aging, joint injury or trauma, repetitive joint stress on the joints, genetic predisposition, and obesity. Synovial fluid viscosity also decreases as the cartilage deteriorates. 

The bones start rubbing against each other, leading to pain, stiffness, swelling, and decreased mobility in the affected joint. It should be noted that an Orthovisc injection is not a steroid but is actually closer in nature to a dermal filler.

Orthovisc works by replenishing the depleted synovial fluid in the joint, which helps restore optimal joint function. The injected hyaluronic acid in Orthovisc acts as a lubricant and shock absorber, providing cushioning and reducing friction between the bones. This helps alleviate pain, improve joint mobility, and restore overall joint health.

Each injection includes: 

Hyaluronan: 30 mg
Sodium Chloride: 18 mg
Injection Water: up to 2.0 ml

Benefits & Side Effects of Orthovisc

Restoring full functionality to the knee isn’t a small feat, but it’s not the only advantage of using Orthovisc. Other benefits include: 

Pain relief: One of the primary benefits of Orthovisc is its ability to provide effective pain relief for individuals with knee osteoarthritis. The hyaluronic acid in Orthovisc acts as a lubricant and cushion in the joint, reducing friction and alleviating pain during movement. This can significantly improve the overall quality of life for patients by reducing discomfort and allowing for increased mobility.

Minimally invasive: Orthovisc offers a minimally invasive treatment approach for knee osteoarthritis. Unlike surgical interventions, injections can be administered in a medical professional’s office without the need for incisions or total anesthesia. This reduces the risks and complications associated with invasive procedures and allows for a quicker recovery time.

Minimal aftercare: Another advantage of Orthovisc knee injections is their minimal aftercare requirements. Following the injection, patients typically experience little to no downtime and can resume their daily activities shortly after the procedure. This convenience and minimal disruption to daily life make Orthovisc a favorable option for individuals seeking effective pain relief without significant post-treatment restrictions.

Nothing in medicine is without side effects, and Orthovisc is no different, but all the side effects are considered negligible. Those side effects are:

  • pain
  • redness
  • allergic reaction
  • swelling
  • bruising
  • heat
  • rash
  • itching

Contraindications and Considerations

While Orthovisc injection treatments can provide significant benefits for individuals with knee osteoarthritis, there are certain contraindications and considerations to keep in mind. These factors help determine their suitability for patients. As a medical professional, it is important to consider each patient carefully and watch for the following contraindications:

Allergies to hyaluronic acid: Patients with a known allergy or hypersensitivity to hyaluronic acid should not receive injections. An allergic reaction can lead to adverse side effects and complications.

Infections in your knee or the skin nearby, including septic arthritis: Orthovisc injections are not recommended for patients with active infections in the knee joint or the surrounding skin. The presence of an infection can increase the risk of complications and interfere with the effectiveness of the treatment.

Orthovisc should not be administered to children or nursing and pregnant women, as its use has not been tested on them. The injection wasn’t tested on any other type of joint, so its use is not recommended for anything other than knee joints. The patient should first explore traditional methods like physical therapy and exercise before undergoing an Orthovisc treatment.

Aftercare

Proper aftercare is crucial for optimizing treatment outcomes and ensuring the patient’s well-being. Here are some essential aftercare guidelines for them to follow:

Rest and avoid strenuous activities: After Orthovisc is administered, patients should rest and avoid engaging in strenuous activities such as jogging, heavy lifting, sports, or standing for a longer period of time (several hours) for at least 48 hours because it may put excessive strain on the treated joint. The hyaluronic acid should be given time to settle properly and start working. It should be noted that most patients start feeling knee pain ease up after the third injection, while the full effect can be felt after four to six weeks

Apply ice: Applying ice packs to the treated area can help reduce swelling and minimize discomfort. Applying ice for short durations, typically 10-15 minutes at a time, is recommended several times a day. The patient shouldn’t apply the ice directly to the skin. 

Avoid soaking the knee in water: Patients need to avoid soaking the treated knee in water for 48 hours after the Orthovisc injection, but showering is perfectly fine. This helps prevent the risk of infection at the injection site. 

Persisting stiffness: It’s not uncommon for the knee to feel stiff in the first few hours after the procedure. If the stiffness persists for more than 4 hours, the patient should consider taking an anti-inflammatory drug.

Conclusion

Orthovisc has emerged as a promising treatment for individuals with knee osteoarthritis. It offers effective pain relief and improved joint function, enhancing patients’ overall quality of life. With its minimally invasive nature, convenient administration, and easy aftercare requirements, Orthovisc is a valuable option for managing knee osteoarthritis and postponing knee surgery for another date. 

FAQ

How long does an Orthovisc injection last?

Effects typically last four to six months, and therapy can be repeated as often as required. 

What are the side effects of Orthovisc injections?

The most common side effects of Orthovisc are pain, allergic reactions, bruising, swelling, redness, rash, itching, and increased body heat in the area. 

How long does it take for Orthovisc to take effect?

Most people start feeling the effects after the third injection, but it takes four to six weeks for the medication to start working completely. 

References

  1. Why is Osteoarthritis an Age-Related Disease?; A. Shane Anderson (MD) and Richard F. Loeser (MD); Feb 2010
  2. A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee; Jacquelin Peck (MD), Annabel Slovek (AGACNP), Paulo Miro (BS), Neeraj Vij (BS), Blake Traube (BS), Christopher Lee (MD), Amnon A. Berger (MD, Ph.D.), Hisham Kassem (MD), Alan D. Kaye (MD, Ph.D.), William F. Sherman (MD, MBA), and Alaa Abd-Elsayed, (MD, MPH); Jul 2021
  3. Hyaluronic Acid (HA) Viscosupplementation on Synovial Fluid Inflammation in Knee Osteoarthritis: A Pilot Study; Heather K Vincent, Susan S Percival, Bryan P Conrad, Amanda N Seay, Cindy Montero, and Kevin R Vincent; Sep 2013
  4. Hyaluronan and synovial joint: function, distribution, and healing; Tamer Mahmoud Tamer; Sep 2013
  5. Synovial inflammation in osteoarthritis progression; Elsa Sanchez-Lopez, Roxana Coras, Alyssa Torres, Nancy E. Lane, and Monica Guma; Feb 2022
  6. A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee; Jacquelin Peck (MD), Annabel Slovek (AGACNP), Paulo Miro (BS), Neeraj Vij (BS), Blake Traube (BS), Christopher Lee (MD), Amnon A. Berger (MD, Ph.D.), Hisham Kassem (MD), Alan D. Kaye (MD, Ph.D.), William F. Sherman (MD, MBA), and Alaa Abd-Elsayed (MD, MPH); Jul 2021
  7. Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis; Egemen Ayhan, Hayrettin Kesmezacar, and Isik Akgun; Jul 2014.
  8. Biocompatibility study of different hyaluronan products for intra-articular treatment of knee osteoarthritis; Keiji Yoshioka, Madoka Katayama, Takeo Nishiyama, Kohei Harada, Sawako Takeshita, and Yuji Kawamata; Sep 2019
  9. Clinical effects of intraarticular injection of high molecular weight hyaluronan (Orthovisc) in osteoarthritis of the knee: a randomized, controlled, multicenter trial; David Neustadt, Jacques Caldwell, Mary Bell, John Wade, and Joseph Gimbel; Oct 2005

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