Hyaluronic acid has been used since the 1990s to treat osteoarthritis of the knee. Over the last fifteen years, its use has increased significantly.

Osteoarthritis or inflammation of the shoulder, knee or hip: when should you consider viscosupplementation?

Osteoarthritis is a progressive destruction of cartilage caused by the accumulation of mechanical stresses and by aging.

Osteoarthritis joints usually are relatively deficient in hyaluronic acid. Providing your joint with additional hyaluronic acid once or twice a year would slow down the degradation process and, consequently, reduce the symptoms.

So, viscosupplementation is indicated for osteoarthritis of the knee, hip, ankle, and sometimes even shoulder osteoarthritis.

As previously mentioned, hyaluronic acid is involved in the healing process of tendons and ligaments.

Viscosupplementation can sometimes be considered to help heal certain soft tissue injuries, such as chronic epicondylitis and acute ankle sprains.

Your doctor may even suggest viscosupplementation for specific musculotendinous injuries related to the shoulder or knee.

Example of conditions that can be treated with viscosupplementation:

  • Osteoarthritis of the knee or gonarthrosis
  • Osteoarthritis of the hip or coxarthrosis
  • Osteoarthritis of the ankle
  • Arthrosis of the shoulder or glenohumeral arthrosis
  • Chronic epicondylitis
  • Sprained ankle

Hyaluronic acid, what is this product that is injected?

Hyaluronic acid is a natural substance already present in our joints and connective tissues (support tissues).

Hyaluronic acid is a key component of synovial fluid, which is the oil that surrounds our joints and nourishes our cartilage.

Hyaluronic acid is also found in our periarticular tissues, such as tendons and ligaments. It seems to be involved in the healing process of these peri-articular structures.

What should you expect during the procedure? What is the treatment?

The procedure is similar to cortisone injections. In cases of osteoarthritis, the physician will have to make sure that he or she is inside the joint before injecting the hyaluronic acid.

In cases of periarticular injuries, he or she will inject the hyaluronic acid around the injured tendon or ligament.

How long should you rest after a hyaluronic acid infiltration?

It is recommended to rest for a short period of time, about 48 hours. The benefits may take a few days to a few weeks to be felt.

In some cases, hyaluronic acid can be associated with a cortisone derivative to achieve faster symptom regression and pain relief.

Do you need to repeat the hyaluronic acid injection?

Because osteoarthritis is related to aging, it is recommended to repeat viscosupplementation at least once a year. You do not have to wait for the symptoms to recur.
However, for tendons and ligaments, one or two infiltrations in total are usually sufficient.

What are the side effects and possible complications?

Following the hyaluronic acid injection, you may experience local pain and some swelling. These are relatively rare side effects. They are generally benign and short-term.

Applying ice may help relieve this post-injection pain.

When a patient experiences such a side effect, it is recommended to change the product, i.e. to use hyaluronic acid from another manufacturer.

In very rare cases, a patient may develop significant redness accompanied by fever. In this case, it is important to consult a doctor quickly to rule out an infection.

Some cases of contraindications

Viscosupplementation is contraindicated for patients who are allergic to any of the ingredients in the hyaluronic acid product.

Like other types of injection, viscosupplementation is not recommended if a patient has a skin condition or an infection at the injection site.

What is the difference between an injection and an infiltration?

In fact, infiltration is the procedure during which the doctor injects (or introduces) a substance inside the body. The doctor injects hyaluronic acid and performs an infiltration: this is the purpose, the name of the procedure. An infiltration is an injection.

How much does an infiltration cost? Is it covered?

The infiltration technique is covered by the RAMQ. The patient will have to pay for the product. In this case, the cost of hyaluronic acid will range from $150 to $450, depending on the quantity. The product is generally reimbursed by the CNESST, SAAQ and most private insurance plans.

The infiltration technique is covered by the RAMQ.

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