Gel injection for knee and shoulder

DR. DEPAEPE

VISCOSUPPLEMENTATION – HYALUORIC ACID INFILTRATION – “GEL INJECTION” FOR KNEE AND SHOULDER

Viscosupplementation is the injection of a hyaluronic acid or "gel" into a joint.

1. WHAT?

Hyaluronic acid is a gel-like substance that is normally present in healthy joints. It functions as a lubricant, shock absorber and thus protector of the cartilage layers.

In osteoarthritis, both the quality and quantity of this body's own hyaluronic acid are noticeably reduced. It becomes more difficult to nourish and protect the damaged cartilage.

We try to control the symptoms of osteoarthritis by artificially injecting (chemically imitated) hyaluronic acid. Repeated injections of hyaluronic acid could stimulate the production of the body's own hyaluronic acid. Usually 3 injections are necessary to achieve this result.

About 30% of treated patients become completely pain-free, while 20% will experience no effect.

The effect after the injections can last up to 18 months. If complaints recur, the injections can be repeated.

In the past, hyaluronic acid was mainly made from rooster combs (risk of allergic reaction to chicken proteins), nowadays most products are biotechnologically prepared from bacterial cultures (no more allergic reactions).

2. HOW?

During consultation, an injection is administered to the knee or shoulder joint; This is a simple injection and is less painful than many would suspect.

If there is too much fluid in the joint, a cortisone preparation is sometimes injected first.

After injection there may sometimes be some local reaction, e.g. pain, warmth, slight swelling, stiffness of the joint. These complaints disappear spontaneously over a period of 1 to 3 days. If these complaints are present, ice treatment can alleviate them. If ice treatment proves insufficient, you can safely take a painkiller.

3. INDICATIONS

KNEE

In the knee, we mainly treat early osteoarthritis of the knee (grade 1 to 3). The hyaluronic acid infiltrations are a "non-operative treatment" for proven cartilage lesions in the knee.

SHOULDER

• Osteoarthritis of the shoulder
• Osteoarthritis of the shoulder due to rotator cuff tears
• Rotator cuff tears: studies have shown a reduction in pain and, in combination with physiotherapy, an improvement in function and mobility. However, it is not a definitive solution that can heal the crack!
• Capsulitis or frozen shoulder: hyaluronic acid can help reduce pain and inflammation and thus improve mobility.

COMPLICATIONS?

Gezien dit een namaak van een lichaamseigen product is, zijn complicaties zeer zeldzaam. Theoretische complicaties kunnen zijn: lokale allergische reactie, infectie of bloeding. Neem zo snel mogelijk contact op indien u zou vermoeden dat dit zich voordoet bij u.

4. FACTS

• Can I exercise after an injection? We recommend not to do any intensive physical strain for the first 48 hours. You can continue with your normal daily routine.
• I don't feel any improvement after my first injection? The effect of a hyaluronic acid injection is not immediate. Often there is only relief from pain and stiffness after the 2nd or 3rd.
• How many injections can I get? There is no maximum dose. We usually try to stick to the most classic schedule of 3 injections. If complaints arise again after a few months of improvement, these injections can be repeated or we can opt for a "reminder single shot".
• How many injections should I get? We use the schedule with 3 injections. In research, the results of pain and stiffness are better in people treated with 3 injections compared to people who received 1 injection.
• Will my osteoarthritis progress less quickly? Will I be less likely to need a "new knee" if I receive regular injections? No! Osteoarthritis is still an "incurable disease". To date, there is no scientific evidence that injections of hyaluronic acid could stop the osteoarthritis process or grow new cartilage. There is a proven effect by reducing pain, reducing inflammation and reducing stiffness and stiffness.
• Price? Viscosupplementation is a treatment that is not reimbursed by the health insurance company. The price is around 40 euros for a high-quality basic product, the single shot products cost about double. Some "high molecular weight" products in single-shot can cost well over 200 euros.
• Why doesn't the treatment help me? 20% van de behandelde patiënten zal geen resultaat ondervinden van de "gel inspuitingen". Mensen met obesitas (BMI > 30) en mensen met ver gevorderd stadium van artrose hebben minst kans op goede uitkomst van de behandeling.