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

Knee osteoarthritis is often associated with older age, but symptoms can also affect younger adults, particularly those with previous joint injuries or other risk factors. Common treatment approaches include exercise, physical therapy, pain-relieving medications, and intra-articular therapies. When these measures do not provide adequate relief, an Orthovisc injection may be considered as a minimally invasive option for managing knee osteoarthritis pain before progressing to surgery.

Over the past two decades, viscosupplementation has become an important option for patients seeking non-surgical symptom management. In this article, we will examine how Orthovisc works, its potential benefits and side effects, contraindications, and appropriate aftercare. Licensed healthcare professionals looking to buy Orthovisc online should source the product through reputable medical suppliers that can support product authenticity, appropriate storage conditions, and proper handling throughout the supply chain.

What Is an Orthovisc Injection?

An Orthovisc injection is a viscosupplementation treatment containing a high-molecular-weight form of hyaluronan, a substance naturally found in the body’s joints and synovial fluid. Hyaluronan contributes to joint lubrication and shock absorption, helping reduce friction between joint surfaces 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. 

Among the orthopedic injections used for knee osteoarthritis, hyaluronic acid-based viscosupplements such as Orthovisc provide a non-surgical approach aimed at improving lubrication and reducing OA-related joint pain.

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. An Orthovisc injection is not a corticosteroid treatment; instead, it delivers hyaluronan directly into the knee joint to supplement the properties of synovial fluid.

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: One more advantage to Orthovisc knee-joint injections is the minimal requirements for aftercare. Following the completion of the injection, patients can expect nearly no downtime, being able to resume regular daily activities shortly after the procedure. This level of convenience and minimal schedule disruption makes Orthovisc a favorable choice for individuals in search of effective pain relief without any 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 an Orthovisc injection can provide symptom relief for appropriately selected patients with knee osteoarthritis, certain contraindications and clinical considerations must be assessed before treatment. 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

An Orthovisc injection offers a minimally invasive viscosupplementation option for appropriately selected patients with knee osteoarthritis who have not obtained sufficient relief from more conservative treatments. By supplementing hyaluronan within the joint, Orthovisc may help reduce pain and improve joint function while allowing some patients to postpone more invasive interventions.

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. 

Citations

[1] Anderson, A. Shane, and Richard F. Loeser. “Why Is Osteoarthritis an Age-Related Disease?” Best Practice & Research Clinical Rheumatology, vol. 24, no. 1, 2010, pp. 15–26. https://doi.org/10.1016/j.berh.2009.08.006.

[2] Peck, Jacquelin, et al. “A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee.” Orthopedic Reviews, vol. 13, no. 2, 2021, 25549. https://doi.org/10.52965/001c.25549.

[3] Vincent, Heather K., et al. “Hyaluronic Acid (HA) Viscosupplementation on Synovial Fluid Inflammation in Knee Osteoarthritis: A Pilot Study.” The Open Orthopaedics Journal, vol. 7, 2013, pp. 378–384. https://doi.org/10.2174/1874325001307010378.

[4] Tamer, Tamer Mahmoud. “Hyaluronan and Synovial Joint: Function, Distribution, and Healing.” Interdisciplinary Toxicology, vol. 6, no. 3, 2013, pp. 111–125. https://doi.org/10.2478/intox-2013-0019.

[5] Sanchez-Lopez, Elsa, et al. “Synovial Inflammation in Osteoarthritis Progression.” Nature Reviews Rheumatology, vol. 18, no. 5, 2022, pp. 258–275. https://doi.org/10.1038/s41584-022-00749-9.

[6] Peck, Jacquelin, et al. “A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee.” Orthopedic Reviews, vol. 13, no. 2, 2021, 25549. https://doi.org/10.52965/001c.25549.

[7] Ayhan, Egemen, Hayrettin Kesmezacar, and Isik Akgun. “Intraarticular Injections (Corticosteroid, Hyaluronic Acid, Platelet Rich Plasma) for the Knee Osteoarthritis.” World Journal of Orthopedics, vol. 5, no. 3, 2014, pp. 351–361. https://doi.org/10.5312/wjo.v5.i3.351.

[8] Yoshioka, Keiji, et al. “Biocompatibility Study of Different Hyaluronan Products for Intra-Articular Treatment of Knee Osteoarthritis.” BMC Musculoskeletal Disorders, vol. 20, no. 1, 2019, article 424. https://doi.org/10.1186/s12891-019-2815-6.

[9] Neustadt, David, et al. “Clinical Effects of Intraarticular Injection of High Molecular Weight Hyaluronan (Orthovisc) in Osteoarthritis of the Knee: A Randomized, Controlled, Multicenter Trial.” The Journal of Rheumatology, vol. 32, no. 10, 2005, pp. 1928–1936.