If you’re suffering with a long-term knee problem like osteoarthritis, is surgery the only realistic option for you? Not necessarily. There are other ways to treat a chronic knee condition: by focusing on careful management and relief of the painful symptoms, for instance. That’s the idea behind hyaluronic acid injections. Hyaluronic acid is a kind of lubricating fluid that occurs naturally in our bodies. The treatment involves injecting a small amount of this chemical into the space between the knee joint, where osteoarthritis can deplete the body’s own supply of the acid. Although it’s not possible to say in advance whether a person will see benefits from the injection, some patients do report very good results with it. We asked CBO patient Chris – a 53-year-old businessman who uses hyaluronic acid to manage arthritic pain in his knees – to explain what the process is like.

Can you tell us a bit about your knee condition, Chris?

I have osteoarthritis in both joints – so basically the cartilage that protects the bone endings has worn away. Both my knees get pretty sore, but it’s worse on the inside right knee. At that point the contact is nearly bone-to-bone. The cartilage has almost completely worn away.

When did you first realise you had a problem with your knees?

Probably in my late 30s. I noticed I was getting an uncomfortable soreness after football. I’ve played football my whole life. I was a semi-pro when I was younger. At the age of 14, I was playing five games of competitive football a week – plus all the running, sprinting and fitness work that goes along with it. Your knees aren’t really built to do that! In my 30s I was also running on a treadmill every day, not realising how damaging it was to my knees at that point.

What symptoms were you getting with the arthritis?

It started as an aching pain. I’d finish a round of golf and notice they were feeling a bit painful. Or I’d play football – I often played both Saturday and Sunday – then feel really sore on the Monday. Eventually it was so bad I could hardly walk down the stairs. It would be two days before I could walk normally again. I just thought, “I can’t keep on like this.”

Did you realise it was arthritis at the time?

I kind of knew there were issues there, but I just put them down to general wear-and-tear on my body. It was only after I saw a specialist that it was diagnosed as osteoarthritis.

What did you do next?

Initially I had a keyhole operation to remove the ‘loose bodies’ in my knee, which are little bits and bobs of floating tissue that can be really painful if they ‘catch’ in your joint when you’re walking, say, or when you bend over. It’s a common procedure. Several of my friends have had it done, and one or two have noticed a benefit. But I didn’t really benefit from it. It didn’t send the soreness away.

Was knee replacement an option?

It was – a partial or full knee replacement is a route they might steer you down ordinarily. But I didn’t want to contemplate those options. To me they felt like a last-case scenario, really. So I started to look around for other options. That’s when I realised there was this injection you could get.

How does hyaluronic acid treatment work?

It takes place in the clinic. You just sit on the couch, the area around your knee is cleaned and then the solution is injected through the space under the knee socket. There are two different products available – Ostenil Plus and Synvisc – and I usually use Ostenil Plus. The product has also come down hugely in price in the last in the last few years, so it costs less money to get it done now than it did five years ago.

When do you start to notice a change in your knees?

It generally takes a couple of weeks, and then all of a sudden I find my knee pain goes away. I still get soreness from time to time; it’s not bulletproof. But the difference it makes to me is huge.

Does it change the kinds of activities you’re able to do?

Five years ago I couldn’t even play a round of golf, my knee was so painful. Now I golf, work out, swim and, within reason, do whatever I want to do. I can ride on a bike with no issues whatsoever, whereas previously the pain of riding a bike would be quite severe on my knee. I can’t do high agility things like sprinting and football (but then I am 53!). But I now play golf twice a week, go to the gym, walk the dog – pretty much whatever I want to do.

How long do the effects last, in your case?

I find they last for about a year. But admittedly it varies. I had one that lasted for 14 months. The latest one lasted nearly a year to the day.

When do you go back for a repeat injection?

Basically when it starts to feel sore again. I get a four-to-six-week period where, slowly but surely, it starts to get sore again. Once I start to get those early-warning signs, I’ll book myself back in.

Have you experienced any difficulties or side effects with the treatment?

None whatsoever. I’ve now had the same injection for five years consecutively, and I think there has to be a good reason for that. For me, it’s been a revelation. That’s probably the most accurate way I can describe it.

What’s your longer-term plan for your knees?

Ultimately, if there were ever a cartilage-replacement operation and I was in a position to pay for it, that’s what I’d do – because it’s not really my knees that are knackered, it’s the ‘shock absorber’ between the bones that has worn out. But for the moment, for all the time this works, I’ll carry on using this treatment. It’s about the bigger picture, really: not just the ability to use the knee, but the knock-on effect of being agile, of being able to do the things that make me feel good about myself and get those endorphins going. You can’t put a price on that, really.

If you’re interested in finding out more about pain relief for your knees, please get in touch with the team. We’ll be very happy help you explore the different options. Call Cheryl on 01962 826107 to book a quick appointment, or pop your details into our online form, and we’ll be back in touch as soon as possible.