Frequently Asked Questions
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What is osteoarthritis and why does it cause knee pain?
Osteoarthritis (OA) is a degenerative disease of the synovial joints, which causes joint pain and functional impairment. It occurs most frequently in the knees in adults over 50 years old. It is a major cause of disability worldwide. OA, often referred to as “wear and tear” arthritis is caused by the breakdown of the lubricating fluid in the knee primarily affecting the cartilage found on the ends of bones in joints. The combination of these factors causes the bones of the knee joint to rub together causing the knee pain experienced by individuals suffering from OA.
How do hyaluronic acid injections work?
Cartilage and naturally occurring synovial fluid between bones helps facilitate a smooth gliding motion within joints. Over time, this fluid breaks down and dries, causing natural wear and tear of the cartilage which makes it difficult to keep the knee lubricated. This can result in painful stiffness of the knee.
Hyaluronic acid injections work by replacing the lost synovial fluid to relieve joint pain and restore mobility.
What conditions are treated with hyaluronic acid injections?
The FDA has approved hyaluronic acid injections, for the treatment of osteoarthritis. Osteoarthritis is the result of cartilage degeneration and a loss of synovial fluid (the fluid within the knee). Pain from arthritis often restricts knee mobility, causing discomfort and reduced knee function.
How do I know if I am a candidate for Hyaluronic Acid knee injections?
We offer a complimentary consultation to learn more about your condition. If we believe based on that assessment that you will benefit from the procedure we will set you up with an initial appointment covered by your insurance to take an image of your knee to confirm that the knee is in a condition that will likely benefit from the hyaluronic acid.
When should I have a hyaluronic acid injection?
If you are experiencing knee pain you may benefit from hyaluronic acid injections. There are many factors that lead to osteoarthritis.
Age: The ability of cartilage to heal itself decreases as we age. Osteoarthritis typically affects people middle-aged and older.
Heredity: Certain genes have been linked to osteoarthritis. Inherited traits, such as being bowlegged, knock-kneed, or double jointed can also put you at greater risk for the disease.
Weight: The more you weigh, the more stress you put on your knee joints.
Injury: Previous knee injury, such as a sports injury, can lead to osteoarthritis later in life.
Repetitive Stress: People in occupations that involve repeated kneeling or squatting, or heavy lifting and walking, are vulnerable to repetitive stress injuries in the knee. This makes them more likely to develop osteoarthritis.
Other illnesses: If you have had other problems with your knee, such as gout, knee infection, or Lyme’s disease, your risk for osteoarthritis increases.
Why hyaluronic acid (HA) injections instead of knee surgery or medications?
In addition to HA injections there are various traditional options available to treat the symptoms of knee pain including medications for pain and anti-inflammation and surgery. Each of these traditional options come with side effects to consider.
Medications can include acetaminophen (like Tylenol), opioids (like Oxycontin, etc.), and non-steroidal anti-inflammatory drugs (NSAIDs; Advil, Aleve etc.). When administered over a long time many of these result in significant heart and intestinal toxicity (FDA mandated Black Box Warnings), or addiction issues. They can also place patients with other underlying conditions such as heart disease at particularly serious risk.
Surgery: Partial or full replacement of a knee joint is an invasive procedure that can take up to 12 months or more from which to fully recover and many patients still experience joint pain. If you condition is severe enough this may be the only option, however, many patients do not qualify for the surgical risk. It is also important to consider that replacing your knee with an artificial joint is permanent
HA Injections: In contrast, HA injections clinical benefit tends to last six months or longer, and with minimal side effects. They also have no known drug interactions that could create a clinical concern. The procedure is used as an alternative for people who do not respond well to medications, corticosteroid injections, physical therapy, or other treatments. For patients with severe or advanced arthritis, and those with total cartilage deterioration, the procedure may not be effective and is not recommended.
Does it hurt?
Most patients experience very little or no discomfort at all. In rare occurrences the most common short-term side effects are minor pain at the injection site and minor buildup of joint fluid.
How many hyaluronic acid injections are required?
Depending on the extent of your joint damage and pain symptoms, 3 injections are given one week apart.
What precautions should I take following the hyaluronic acid injection?
After the injection, it is suggested that you rest at home for the remainder of the day of your procedure. Avoid excessive stress on the injected knee for up to 48 hours. You must not run, jog, lift weights, or engage in prolonged standing.
What are the side effects of hyaluronic injections?
Most patients experience very little or no discomfort at all. In rare occurrences the most common short-term side effects are minor pain at the injection site and minor buildup of joint fluid. These get better within 12- 24 hours. Side effects are a very rare occurrence, but may include temporary burning, itching, tenderness, and muscle stiffness.
Do hyaluronic acid injections work?
Studies have shown that greater than 90% of patients experience some level of pain reduction with most experiencing significant pain reduction. It does vary from individual to individual but the very low incident of even temporary side effects make it worth considering.
The peak benefit of the hyaluronic acid injection is felt 1-2 weeks after the procedure. The benefits of the procedure can last for months. In clinical studies many patients experience 6 or more months of pain relief.
What payment options are available?
Medicare and most private insurance carriers cover hyaluronic acid injections. Depending on your insurance, you may have co-pays or deductibles that apply. We take care of the billing and verification of benefits so there is nothing to worry about on your part.
For each injection, we complete the prior authorization and can even assist with financing for any part of the treatment that isn’t covered by insurance.