Treatments Help Soothe Arthritic Knees

Arthritic knees are a constant concern for millions of Americans, causing discomfort or, in many cases, limiting movement.

According to Dr. John Cianca, an assistant professor of physical medicine and rehabilitation at Baylor College of Medicine, several lubricating solutions are now available, two of which are Synvisc and Hylagan. They have been successfully used to treat osteoarthritis, or arthritis of the knee.

Osteoarthritis is a chronic, progressive disease of the joint that involves the breakdown of cartilage. As the smooth cartilage becomes pitted and frayed, it becomes less elastic and is susceptible to overuse and injury. In addition, the fluid surrounding the joint also may lose its ability to cushion and lubricate.

"The normal joint is surrounded by a fluid that acts as a lubricant and shock absorber," said Dr. Cianca. "Manufactured forms of this substance can be injected into the knee as a substitute. They don't cure osteoarthritis, but they have been shown to reduce pain in the knee."

In more severe cases, large areas of the cartilage may wear away completely and bones can scrape against each other. Cartilage breakdown may cause the joint to lose its shape, with the bone thickening and forming spurs. Pieces of bone or cartilage also may float in the joint, leading to further damage and pain.

When first diagnosed with osteoarthritis, patients may try physical therapy and exercise, weight control or non-prescription pain relievers. A second option might be prescription pain relievers and injections into the joint to stop inflammation or to provide pain relief. The final option would be knee replacement or arthroscopic surgery.

The Synvisc treatment consists of three injections, given one week apart over a three-week period. It reportedly has a high success rate, with many patients seeing positive results within six to eight weeks. In most cases, side effects are minimal, although some patients experience temporary discomfort and swelling. Synvisc is not recommended for people who are allergic to chicken or eggs.

The Hylagan treatment involves a series of three to five injections over a five-week period. It appears to have few side effects, Dr. Cianca said.

"Both treatments can be effective in reducing pain from osteoarthritis by acting as a cushion and lubricant for the knee," said Dr. Cianca. "When injected, the liquid covers the inside of the knee and literally bathes it."

Lubricating solutions represent another option for osteoarthritis sufferers, offering several months of relief. However, they are no substitute for arthroscopic surgery or a knee replacement in more severe cases.

Osteoarthritis can be caused by factors such as overuse or occupational injuries, obesity, poor joint alignment, sports injuries or family history. Approximately 17 million people in the United States experience osteoarthritis pain, with nearly 9.5 million affected in the knees.

"These lubricants aren't effective for everyone, but they've had the greatest impact on patients with mild to moderate knee pain due to degenerative changes," said Dr. Cianca.

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©2006 Texas Medical Center

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