Viscosupplementation in osteoarthritis of knee

Abstract

Osteoarthritis (OA) is a complex joint disease and is caused by inflammatory mediators, along with a process of "wear and tear of cartilage". Osteoarthritis results in cartilage degradation, synovial inflammation, subchondral bone eburnation, degeneration of menisci, and capsular hypertrophy, which takes part in the pathogenesis of OA. Pain is the predominant symptom of OA. However the exact mechanism causing pain is multifactorial and is still not well known. Viscosupplementation with intraarticular hylauronic acid (HA) promotes chondrocyte hyaluronic acid synthesis and prevents the further cartilage degradation and may possible help to promote the cartilage regeneration. It is also postulated to reduce the production of inflammatory mediators and matrix metalloproteinase involved in OA. Viscosupplementation reduces osteoarthritis symptoms in early to moderate OA, and improves functional outcome, if other conservative treatment modalities are ineffective. Viscosupplementation might delay the need for knee replacement surgery. Prospective study was conducted to know the efficacy of Viscosupplementation with hyaluronic acid (HA) in patients with osteoarthritis knee joint.1200 patients meeting the inclusion and exclusion criteria with OA knee were included in the study. The patients were categorised based on radiological classification of Kellgren and Lawrence. Parameters includesVisual Analogue Scale (VAS) while performing activity of daily living modified the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. We found that there is significant improvement in pain and functional outcome at 6 months of follow up. Here We came to a conclusion that intraarticular hylauronic acid injection is potentially a effective treatment for osteoarthritis of knees in multiple doses and is adjunct treatment to oral analgesics to decrease the pain and its doses. It helps in improving the function in early osteoarthritis knee joint and might delay the need for future knee surgery.