Hyaluronic injections are an established treatment of early arthritis.

Joints have a natural lubricating fluid – synovial fluid that contains “hyaluronic acid, (HA)”.  Viscosupplementation involves injecting the knee with a commercial version of HA.  In joints that are very swollen, the existing fluid fluid is removed (often 50-80 mls), before injecting the HA.  Not only is the existing fluid tight and uncomfortable, it contains inflammatory mediators “cytokines” that need to be removed.

HA (Hyaluronic Acid) is either made completely synthetically (Durolane) or using chicken related products (Synvisc).  Both work equally, indeed McGrath’s paper in a randomised controlled trial demonstrating Durolane reduces analgesic use up to nine months after the injection.  A disadvantage of the Synvisc is the potential to allergy.

The HA is not funded by the PBS or Medicare, so costs the patients approx $475 in addition to appointment fees. The $475 cannot be claimed from Medicare or any private health insurance policy.  The knee joint can be injected at BallaratOSM – you just need an appointment with one of the doctors/surgeons who does the injections.  The hip joint can also be injected, but under CT control with one of a radiology colleagues.

 

References:

McGrath et al.  A Comparison of Intra-Articular Hyaluronic Acid Competitors in the treatment of Mild to Moderate Knee Osteoarthritis. J Arthritis 2013, 2(1)

Agerup et al, Non-Animal Stabilised Hyaluronic Acid – a new formulation for the treatment of osteoarthritis.  Biodrugs 2004 19(1): 23-30