| In osteoarthritis, the cartilage in the joint gradually | | | | Glucocorticoid injections are helpful when there is |
| wears away. During the course of cartilage | | | | evidence of inflammation. |
| degeneration, there is inflammation and resultant | | | | The normal knee joint produces synovial fluid, a thick |
| stiffness and pain. Osteoarthritis may be caused by | | | | slippery substance that nourishes cartilage and allows |
| or aggravated by excess stress on the joint from | | | | smooth gliding of the cartilage surfaces. With arthritis, |
| deformity, repeated trauma, or excess weight. It | | | | the amount of synovial fluid made by the joint is |
| most often affects middle-aged and older people. | | | | reduced. |
| A younger person who develops osteoarthritis may | | | | In instances when other therapies do not provide the |
| have an inherited form of the disease or may have | | | | desired relief, viscosupplements are sometimes used. |
| experienced problems as a result of injury. | | | | These are gel-like substances (hyaluronates) that |
| In rheumatoid arthritis, the joint becomes inflamed | | | | mimic the properties of naturally occurring joint fluid. |
| and cartilage may be destroyed as well. Arthritis not | | | | These hyaluronates actually supplement the viscous |
| only affects joints, it can also affect supporting | | | | properties of synovial fluid. Injection of hyaluronates |
| structures such as:o muscleso tendonso ligaments | | | | is done using either fluoroscopic or ultrasound needle |
| Rheumatoid arthritis often affects people at an earlier | | | | guidance. |
| age than osteoarthritis. | | | | Currently, hyaluronate injections are approved for the |
| Regardless of the type of arthritis causing knee | | | | treatment of osteoarthritis of the knee in those who |
| symptoms, the end result is often the same. A | | | | have failed to respond to more conservative therapy. |
| person who has arthritis in the knee may experience | | | | The number of injections performed varies with the |
| pain, swelling, and a decrease in knee motion. A | | | | type of viscosupplement used. Usually 5 injections are |
| common symptom is morning stiffness that gets | | | | required for the best response. |
| better as the person moves around. Sometimes the | | | | Currently, there are five FDA approved |
| joint locks or clicks when the knee is bent and | | | | hyaluronates:o Hyalgano Synvisco Euflexao Supartzo |
| straightened, but these signs may occur in other | | | | Orthovisc |
| knee disorders as well. The doctor may confirm the | | | | Sometimes, a physician will perform an arthroscopy |
| diagnosis by performing a physical examination and | | | | before providing viscosupplement. Also, a special type |
| examining magnetic resonance (MR) scans, which | | | | of brace to help unload the narrowed part of the |
| reveal the inner architecture of the knee. | | | | knee may be used to help the viscosupplement work |
| Most often arthritis in the knee is treated initially with | | | | better. |
| pain-reducing medicines, such as analgesics and | | | | Use for other joints is being studied. Studies have |
| anti-inflammatory medicines. | | | | shown effectiveness for the shoulder, hip, and ankle. |
| Exercise is essential to restore joint movement and | | | | We published a study a few years ago showing |
| strengthen the knee. Losing excess weight can also | | | | these viscosupplements are effective for |
| help people with osteoarthritis. | | | | osteoarthritis affecting the base of the thumb. |