Healthy cartilage works in harmony with bones, muscles, tendons, ligaments, and other support structures to maintain joint function and mobility. If you don’t have cartilage, then you probably have bone on bone joint problems. Up until just recently, treatment options for bone on bone joint problems were fairly limited.

Millions of Americans are suffering from joint pain. Known also as osteoarthritis (OA), when a joint reaches an advanced stage of OA the joints may become bone-on-bone and range of motion can be very limited and it is typically very painful.

For patients looking for relief from OA pain, and who want to avoid or delay joint replacement surgery,viscosupplementation has emerged as an alternative treatment for osteoarthritis of the knee, hip, and shoulders.


A Disease of the Cartilage

Osteoarthritis is primarily considered a disease of the cartilage. Cartilage is a connective tissue found in many areas of the body. It is a firm tissue but is softer and much more flexible than bone, whose primary functions is covering and protecting the ends of the long bones at joints.

As cartilage wears away, the role it serves as a shock absorber and lubricant (to protect the ends of the bones and allow friction-free movement) is affected.

There are no blood vessels in cartilage to supply the tissue with nutrients.  Instead, nutrients diffuse through a dense connective tissue surrounding the cartilage (called the perichondrium) and into the core of the cartilage.

Due to the lack of blood vessels, cartilage grows and repairs more slowly than other tissues which is why viscosupplementation is such a good alternative treatment.


Viscosupplementation – A Promising Alternative 

Viscosupplementation is a lubricating cushion injected between the rubbing bones thus minimizing the pain and discomfort of osteoarthritis. A gel-like fluid called hyaluronic acid is injected into the joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. 

Typically, patients with osteoarthritis have a lower-than-normal concentration of hyaluronic acid in their joints. The theory is that adding hyaluronic acid to the affected joint will facilitate movement and reduce pain.


Viscosupplementation is ideal for patients with mild to moderate OA of the knee.

It may be especially useful for patients who have not responded to other OA treatments, such as physical therapy, weight loss, pain relievers, and cortisone injections.

The benefits of viscosupplementation injections are not immediate. Because the injections are given over time, you may begin to feel some benefit after the first injection, but the greatest benefit may not be felt until several weeks after your first injection. Most patients report the greatest decrease in discomfort occurs eight to 12 weeks after the initial injection. The injections should be repeated every six months for greatest relief.

But how can you be sure that your symptoms are related to OA?

OA Symptoms 

For people that are suffering from OA, symptoms can be life changing and painful.

Typical symptoms may include:


  • Swelling
  • Pain that increases when you are active, but gets a little better with rest
  • Feeling of warmth in the joint
  • Stiffness in the knee, especially in the morning or when you have been sitting for a while
  • Decrease in mobility of the knee, making it difficult to get in and out of chairs or cars, use the stairs, or walk
  • Creaking, crackly sound that is heard when the knee moves



What Causes Bone on Bone Osteoarthritis? 

The most common cause of osteoarthritis is age. Almost everyone will eventually develop some degree of osteoarthritis. In addition to age there are several additional factors that may increase the risk of developing significant arthritis at an earlier age.

  • Weight. Increases in weight as we age puts pressure on all joints, but particularly the knees. Every pound of weight gained places an additional 3 to 4 pounds of pressure on your knees.
  • Heredity. This can include genetic mutations that might make a person more likely to develop osteoarthritis of the knee. It may also be due to inherited abnormalities in the shape of the bones that surround the knee joint.
  • Gender. Women as they age (particularly over age 55) are more likely than men to develop osteoarthritis.
  • Repetitive stress injuries. People with occupations that includes a lot of activity such as kneeling, squatting, or lifting heavy weights (55 pounds or more), are more likely to develop osteoarthritis of the knee because of the constant pressure on the joint.
  • Athletics. Athletes should take precautions to avoid repetitive stress injury. Running, soccer and basketball can be hard on the knees. Tennis, baseball can be hard on elbows and shoulders. All of these activities can increase cartilage damage if not managed properly.
  • Other illnesses. People with rheumatoid arthritis, the second most common type of arthritis, are also more likely to develop osteoarthritis. People with certain metabolic disorders, such as iron overload or excess growth hormone, also run a higher risk of osteoarthritis.

If you are suffering from pain in a joint, consider a consult with a licensed physician to determine if viscosupplementation a viable form of treatment to relieve your pain.

As with any form of medical treatment, you should consult with your physician before embarking on any treatment plan. The information contained in this article is for informational purposes only and should not be deemed accurate for the purposes of diagnosing your particular medical condition

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