Osteoarthritis of the knee causes more disability in walking, stair climbing, and housekeeping than any other disease.1
The most commonly used treatment for osteoarthritis of the knee is acetaminophen (Tylenol®
), but acetaminophen ranks as one of the least effective treatments!2
Its small effect size does not even reach the threshold of clinical significance for knee osteoarthritis. Steroid injections provide fast relief. We can provide this treatment, but we would like to offer you treatments that provide a more lasting solution to osteoarthritis of the knee, and a solution that protects the structures of your knee better. In addition to exercise therapy we can literally inject the lubrication back into your knee.
Hyaluronan (also known as hyaluronic acid or just HA for short) is a lubricant that occurs naturally in joints. When people have osteoarthritis, the hyaluronan is less abundant and smaller. Periodic injections of hyaluronan provide more lasting relief and protect the knee from cartilage damage.
More Effective than Steroids
High-quality medical studies show that viscosupplementation with hyaluronan reduces the pain in osteoarthritic knees 40% to 50%.3 Six months after treatment, hyaluronan injections resulted in greater symptom relief than steroid injections.4
But these studies were limited. Most of these studies only used palpation-guided injections. In other words, the doctors only used touch to decide where to place the injection. Primary Spine & Rehab uses ultrasound-guided injections, because this method is more accurate and shown to get better results for our patients. For instance, Sibbitt and colleagues find that ultrasound-guided injections increase the responder rate 38%, increase therapeutic duration 32%, and reduce outpatient costs 33%.5
Joint Protection from Within
The protection of your knee provided by viscosupplementation is more than theoretical. When knees that received steroid injections are compared to knees that received viscosupplementation, the viscosupplementation is shown to reduce the grade and extent of cartilage damage.6
Our highly qualified physical therapists can design an exercise therapy plan targeted for reducing pain, improving flexibility, and improving leg strength. This can keep you moving up and down those stairs with greater ease. This is also important because full range of motion and well conditioned muscles will help reduce the shock in your knees and absorb some of the shock traveling through your knees. Reducing the stresses in your knees better protects the structures in your knees for your long-term mobility and comfort.
- van Dijk G, Dekker J, Vennhof C, et al. Course of functional status and pain in osteoarthritis of the hip or knee: a systematic review of the literature. Arthritis Rheum. 2006; 55: 779-85.
- Bannuru R, Schmid C, Kent D, et al. Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and meta-analysis. Ann Intern Med. 2015; 162 (1): 46-54.
- Colen S, van den Bekerom M, Mulier M, Haverkamp D. Hyaluronic acid in the treatment of knee osteoarthritis: a systematic review and meta-analysis with emphasis on the efficacy of different products. BioDrugs. 2012; 26 (4): 257-268.
- Jones A, Pattrick M, Doherty S, Doherty M. Osteoarthritis and Cartilage (Osteoarthritis Research Society). 1995; 3 (4): 269-273.
- Sibbitt W, Band P, Chaves-Chiang N, et al. A randomized controlled trial of the cost-effectiveness of ultrasound-guided intraarticular injection of inflammatory arthritis. The Journal of Rheumatology. 2011; 38 (22): 252-263.
- Frizzier L, Ronchetti I. Intra-articular treatment of osteoarthritis of the knee: an arthroscopic and clinical comparison between sodium hyaluronate (500-730 kDa) and methylprednisolone acetate. J Orthopaed Traumatol. 2002; 3: 89-96.