Knee pain that’s caused by arthritis can be debilitating – persistent, obstructive, often impossible to ignore.
For some patients, the best long-term solution to this kind of pain is an operation to partially or totally replace the knee joint. But that isn’t necessarily the right course of action for everyone. Sometimes it’s a case of monitoring and treating the knee to manage and reduce those painful symptoms.
That’s where hyaluronic acid injections come in. Although it sounds rather space-agey, the treatment has actually been around for quite some time; many orthopaedic experts and rheumatologists use it.
The question, of course, is whether they work well to reduce pain. Here are some things to consider.
What is hyaluronic acid?
Hyaluronic acid is a natural substance that’s already present in your body. It’s found in the synovial fluid within our joints – it’s essentially a lubricating chemical that helps the endings of bones to interact smoothly. When osteoarthritis damages the joint cartilage, however, the knee bones begin to rub roughly and painfully against each other.
What do the injections do?
The idea behind hyaluronic injections (also known as hyaluronan injections) is to restore some of that lubricating action to the damaged joint. This can be done quite quickly in clinic. After swabbing your knee, we insert a needle through the skin into the knee capsule, then introduce the hyaluronic acid directly into the inner part of the joint where it can have the most impact.
So… do they actually work?
As with any medical treatment, it’s impossible to guarantee the injections will reduce knee pain in every case.* What we can say is that they work well for many – if not all – patients with osteoarthritis. This anecdotal evidence is supported by studies. One, which used the Oxford Knee Score to determine improvement in symptoms, found about 75% of patients saw benefits after their injection – and that half of those patients again experienced a significant response. Clearly, that’s not everyone. But the results are generally positive.
Who are they best suited for?
In general, hyaluronic injections seem to work best for younger, more active patients. A typical candidate might be someone in their 50s who plays sport and wants to continue to stay active for as long as possible. In the long term, knee replacement may be the best option for them but, for now at least, they feel content to manage their symptoms.
Who might not be suitable?
As with any conservative knee treatment, hyaluronic injections are unlikely to work well if there are significant mechanical issues within your knee joint. If misalignment within the joint is causing the bones to rub against each other severely, for example, adding a lubricating substance won’t alter the underlying problem. Other situations where you might need to avoid having the injections include bleeding or clotting disorders, an infection in the knee, if you’re breastfeeding, or if you have certain allergies.
How long do the injections last?
This varies from patient to patient. But we generally find that when people do experience a reduction in pain after their injections, the benefits can last somewhere between six to 12 months. When those effects begin to wear off, we’ll reassess the situation. You might decide to have another injection. Or we may feel it’s time to consider surgery.
Are there any side effects?
There are very few side effects to using hyaluronic acid. But it’s worth saying that some patients do find their knee feels uncomfortable for a few days afterwards. Others find there’s some swelling or stiffness in their joint. But this usually seems to disappear fairly quickly. In general, we find that hyaluronic injections are a good option for arthritis pain management. They won’t work for everyone. But for other patients, they can bring some much-needed relief.
Interested in reading more about this topic? You might find this case study with one of our patients helpful…
Chris’s hyaluronic acid case study
* NICE (the National Institute for Health and Care Excellence) do not currently recommend hyaluronan injections routinely for the management of knee osteoarthritis, but they can still be used in individual patients if your specialist believes they may be beneficial.
Are you suffering from persistent knee pain? If so, it’s important to have it properly investigated. You can do that here in the clinic by booking an appointment with us. We’ll make sure you’re seen, examined and treated as soon as possible.