In a normal joint, there is a layer of joint (synovial) fluid between the bones and cartilage, which prevents the hard tissues from coming into contact with each other and protects against wear and tear. The lack of this fluid causes destruction of the cartilage tissue, leading to inflammation, chronic pain and, later, to joint thinning and degenerative changes. Hyaluronic acid injections into the joint (hyaluronic injections into the knee joint, hip joint and other large joints) are an effective and popular method of treating joint diseases in modern medicine.
Application of hyaluronic acid injections
Hyaluronic acid is an anatomical component of synovial fluid and can compensate for its deficiency. Hyaluronic acid preparations can completely replace the natural lubrication of the joint. Hyaluronic acid injections are needed when there is a deficiency of synovial fluid that adversely affects the function of the joint.
When hyaluronic acid is injected into the joint, it forms a shock-absorbing layer called a synovial fluid prosthesis or liquid joint prosthesis. These injections are most commonly used in the joints of the lower limbs - knee, hip and ankle.
Composition of hyaluronic acid for injection
Hyaluronic acid injections for joints are composed of several key components that ensure their effectiveness and safety.
The main active ingredient is hyaluronic acid (hyaluronate sodium salt). Preparations may contain varying concentrations of hyaluronic acid, usually 1-2 %.
Hyaluronic acid injections into the joint also contain a buffer solution (usually a saline sodium chloride solution, which is used to create a comfortable environment for the hyaluronic acid to maintain its stability and facilitate the delivery of the drug to the joint), stabilising agents (mannitol or sorbitol), which prolong the action of hyaluronic acid in the body. Some preparations may contain preservatives, but many modern preparations are in sterile disposable syringes, so there is no need to add preservatives.
It is important to note that hyaluronic acid injections do not contain hormones or anti-inflammatory substances, making hyaluronic acid injections safer than corticosteroid injections or NSAIDs.
Indications for hyaluronic acid injections
The main causes of synovial fluid deficiency that lead to hyaluronic acid injections into the joint are:
- Osteoarthritis is a chronic joint disease associated with the thinning and breakdown of cartilage tissue, leading to pain and limited mobility.
- Post-traumatic changes are the consequences of trauma, resulting in deformity and impaired joint function accompanied by pain and inflammation.
- Condition after joint surgery (e.g. arthroscopy) - injections are needed to improve recovery and reduce friction between joint surfaces.
- reduced mobility and joint pain associated with age-related changes or chronic diseases.
- Rehabilitation after inflammatory joint diseases, such as osteoarthritis, where the quality of synovial fluid needs to be improved.
- Excessive physical exertion - for athletes or people whose work involves heavy physical labour, for overweight people, for people with cartilage wear and tear and lack of lubrication for joints.
- Prevent the progression of osteoarthritis in its early stages, when the first signs of cartilage thinning and joint pain appear.
Hyaluronic acid injections in Vilnius are performed at Mano klinika, a specialised clinic offering a wide range of orthopaedic, traumatology and rehabilitation services.
Contraindications to the procedure
Contraindications to hyaluronic acid injections into the joint include the following conditions:
- Acute inflammatory processes in the joint (arthritis, synovitis).
- Infectious diseases of the joints or whole body.
- Allergic reactions to the components of the preparation - individual intolerance to hyaluronic acid or other components of the solution for injection.
- Autoimmune diseases - in some cases, hyaluronic acid injections can aggravate an autoimmune reaction.
- skin lesions or dermatological diseases at the intended injection site (dermatitis, eczema, skin infections).
- Pregnancy and lactation - Hyaluronic acid is not recommended for use during this period due to a lack of data on its effects on the foetus and lactation.
- Systemic blood disorders (e.g. bleeding disorders).
- Early stages of recovery from injury or surgery - during this period, the joint may not be ready for such interventions, increasing the risk of complications.
Before prescribing the injections, the orthopaedic traumatologist at My Clinic performs a series of tests and instrumental diagnostics to rule out any possible contraindications.
Hyaluronic acid injections - features of the procedure
Hyaluronic acid injections into the joints are a modern treatment method aimed at improving joint function and alleviating the symptoms of joint disease.
Features of the procedure:
- Hyaluronic acid is a natural constituent of joint fluid, providing its viscosity and shock-absorbing properties. Therefore, the application of hyaluronic acid to the joint naturally restores the properties of the synovial fluid, reduces friction and prevents the wear and tear of the cartilaginous tissue.
- The injection is performed on an outpatient basis and requires minimal intervention. The minimally invasive procedure takes a few minutes and does not require a long recovery time.
- The medicine is injected directly into the affected joint. Local intervention and targeted action of the drug reduce the likelihood of systemic side effects.
- For maximum effect, several injections (1-3) are usually needed, 1-2 weeks apart, depending on the condition of the joint.
- Hyaluronic acid injections are most commonly given to the large joints (knee, hip, shoulder, elbow and ankle). However, the procedure can be performed on any joint prone to degenerative changes.
Benefits of hyaluronic acid injections
This procedure is unique in that just one injection solves several important problems at once:
- Improves mobility.
- Stops inflammation.
- Reduces pain syndrome. By reducing friction and inflammation, patients experience a significant reduction in pain after just a few treatments.
- It slows down degenerative changes in cartilage tissue, preventing the progression of joint diseases.
- Improves the nutrition of soft tissues and cartilage tissues.
After a course of injections, the results can last from a few months to a year, depending on the stage of the disease and the individual characteristics of the patient.
Hyaluronic acid injections can be a good alternative to surgery for patients with early to mid-stage osteoarthritis. They can help to avoid surgery or postpone it for some time.
Steps for hyaluronic acid injection into the joint
Hyaluronic acid injections into the joint are performed on an outpatient basis.
Procedure steps "Mano Klinika" in Vilnius:
- Preparation of the patient - information about the procedure, examination, assessment of the joint condition.
- Diagnostic procedures - the patient may undergo an X-ray or ultrasound to determine the condition of the joint and the exact injection site.
- Decontamination of the injection site.
- Local anaesthesia (if needed). In most cases, the procedure is almost painless, but injections into large joints may require painkillers.
- Joint puncture - the doctor gently inserts a needle into the joint space. In some cases, if there is excess fluid or inflammation in the joint capsule, the excess synovial fluid or inflammatory exudate may be aspirated (removed) before the hyaluronic acid injection.
- Hyaluronic acid injection. The medicine fills the joint cavity. The injection is carried out under ultrasound guidance.
After the injection, the injection site is again treated with antiseptic. The patient is advised to rest for 10-15 minutes to assess the joint's response to the drug. The doctor may schedule a follow-up appointment to assess the joint and give additional injections if necessary.
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