What is Viscosupplementation?
At the Center for Regenerative Orthopedics at Georgia Bone and Joint, we offer viscosupplementation to help patients recover function faster with less pain and minimize the need for surgery. Many people use slang terms for viscosupplementation such as “gel shots,” “rooster comb,” or “chicken fat,” although this class of medicine is known scientifically as Hyaluronic Acid (HA). Let us explore how this medicine works and why it is used.
Hyaluronans (HA – Hyaluronic Acid)
Hyaluronans are a natural substance found within the joint fluid, which possesses elastic properties (like a lubricant). HA is often called a joint lubricant; however, it also has an anti-inflammatory effect - both mechanical as well as biochemical by stopping breakdown of tissue, reducing levels of prostaglandins (which are often associated with pain in an arthritic joint), interleukin 1, free radicals and cyclic AMP (all “bad actors” in joint disease). They also tend to have a barrier effect by coating the pain receptors on the surfaces of the joint lining. Finally, studies have shown that injections with HA can actually stimulate the body’s own production of Hyaluronan, which may help explain why patients experience longer periods of relief than with corticosteroids.
HA versus Steroids
In medicine, we train to ‘first do no harm’. Physicians started looking for other substances to inject besides steroids that would be much fewer side effects to the joints than traditionally used steroids; HA has been shown to have a nontoxic effect on joints and surrounding tissues. Furthermore, we have multiple head-to-head studies that show patients with osteoarthritis have better pain relief and functional improvement at 6 months when compared to those who received steroid injections.