Osteoarthritis is the most common forms of arthritis. It occurs over time as the cartilage on the ends of bones wears down resulting with bone on bone grinding. Osteoarthritis worsens with time and patients often experience pain, stiffness, loss of flexibility, grinding sensation and formation of bone spurs. Currently there is no cure, and maintaining a healthy weight and healthy lifestyle, custom orthotics, proper shoe gear can help slow the progression.
Knee and ankle implants have a lifespan of 10 years and is often reserved as a last resort treatment option for the older population. An alternative treatment option is the use of hyaluronate injections. Hyaluronate sodium is a derivative of hyaluronic acid a natural substance that surrounds joints. The fluid acts as a lubricant and shock absorbent protecting joints. Over a course of four to eight weeks the use of hyaluronate injections may reduce the need for a joint replacement and help promote production of synovial fluid. In a diseased and arthritic joint, the production of hyaluronate decreases leading to mechanical destruction of the joint and pain. At the moment hyaluronate products are considered as off-labeled use in the ankle joint, but FDA approved for the knee joint.
There are six major trade name products: Euflexxa, Gel-one, Hyalgan, Supartz, Synvisc, Orthovisc. Most of these products are injected into the ankle joint 3 times total, one injection per week. Patients can return to normal daily activities but should postpone strenuous activities for 48 hours after each injection. The benefits typically last from 6-18 months or even longer. Even greater improvement has been observed when combined with arthroscopic debridement according to Carpenter and Motley in 2008.
For more information about viscosupplementation, make an appointment at (626) 517-0022 to see Dr. Sara Shirazi at Pasadena Orthopedics!
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