Osteoarthritis is a chronic degenerative disease that most commonly affects the hips and knees and is associated with joint pain. This pain may ultimately result in the loss of joint function. This disease is caused by 'wear and tear' on the joints themselves. The knee is the most commonly Involved joint. This disease may progress to become so crippling that patient is unable to even walk independently from their bed to the bathroom. The major causes of osteoarthritis are age, gender, obesity, and medical conditions which may predispose to the development of arthritis. Evidence even exists indicating that a hereditary predisposition exists and may contribute to the development of the disease. In fact, certain gene mutations have been identified which seem to point to the potential location for the development of arthritis, for example the hip or the knee.
This disorder needs to be differentiated from another common type of arthritis which is referred to as rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune cells decide to attack the cartilage of the joint and if untreated, may result in damage to the joint surfaces. The signs and symptoms of osteoarthritis are pain, joint stiffness, joint swelling, and typically the loss of function. There are no blood tests are helpful in diagnosing osteoarthritis. The management of osteoarthritis includes non-pharmacological, pharmacological and surgical.
A relatively new procedure available for the management of arthritis is referred to as viscosupplementation, in which a preparation of hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial (joint) fluid. This substance acts as a lubricant to enable bones to move smoothly over each other. These molecules may act as a shock absorber for joint loads during activities. The goal of these medicines is to counteract the changes that occur in the arthritic joint fluid. Arthritic joints ultimately see a decrease in the elastic and viscous properties of synovial fluid which is normally present to help reduce the forces on the joints. These changes occur in osteoarthritis as a result from both a reduced molecular size and a reduced concentration of hyaluronic acid in the synovial (joint) fluid. Viscosupplementation may be a therapeutic option for individuals with osteoarthritis of the knee. Viscosupplementation has been shown to relieve pain in many patients who cannot get relief from non-medicinal measures or analgesic drugs.
Your doctor can help decide what the appropriate selection criteria for these medications are. Ask your provider about the rationale and efficacy of viscosupplimentation in the management of osteoarthritis of knee.
Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com or his office can be reached at 214-252-7039.