Injection Therapy

The following are the most common Viscosupplements that we are injecting into arthritic knees.

• Synvisc
• Orthovisc
• Supartz
• Hyalgan
• Euflexxa

Viscosupplementation Injection

Joint Fluid Therapy, also known as 'viscosupplementation' is intended for patients with osteoarthritis for the knees. The medications are administered by intra-articular injection (ie into the knee joint). A treatment cycle consists of five injections (Hyalgan or Supartz) or three injections (Synvisc, Euflexxa or Orthovisc) given at weekly intervals. Patients who undergo this therapy generally have a lot of knee pain and have often failed other forms of therapy, such as anti-inflammatories (NSAIDS), bracing, canes, weight reduction and activity modification. If you have knee inflammation, including swelling or tenderness, you may be given a different type of injection, for example a single cortisone shot. Since the viscosupplementation injections are given at weekly intervals, a three injection series would be done over a two week period (ie, Monday, Monday, Monday). Don't panic if you get your injections six or eight or nine days apart, it's not likely to ruin your treatment.

Lateral knee injection

Medial knee injection

Draining fluid

Complications of these injections are rare, but can include: infection, inflammation, swelling, pain, soreness, stiffness or atypical reactions of the immune system (the material is made from purified extracts of rooster-comb tissue. In our practice, we first educate you about your options regarding these therapies. If the doctor considers you a candidate for treatment, and you would like to try it:

Cortisone is to reduce inflammation

1. We write you a prescription for the medication
2. You fill it with your pharmacy and insurance co.
3. You schedule your 3 or 5 appointments
4. You come in for each visit, bringing your own medication, and we inject it into your knee
5. You ice the knee for a day or so, and try to not be overly active on the knee
6. After your injection series is complete, you'll generally have a follow-up checkup in about 6 weeks. Of course, call sooner in the unlikely event that there is a problem.

Cortisone

Choosing the type of cortisone

Many types of "cortisone"

• About.com's Cortisone Information
• Quest Diagnostics Information on Cortisone
• Brand Names: DepoMedrol, Celestone, Kenalog