The Rheumatology Services provides relatively painless and comfortable procedures on an outpatient basis, being completed in just a few minutes. A joint injection (intra-articular injection) or soft tissue injection is a procedure used in the treatment of inflammatory conditions, such as rheumatoid arthritis, psoriatic arthritis, gout, tendinitis, bursitis and osteoarthritis (OA). A hypodermic needle is used to inject a drug ( e.g. corticosteroids) into the affected joint along with a local anesthetic agent such as xylocaine. Usually, a single dose of corticosteroids is given into a joint.
Hyaluronic acid or Hyaluronan, because of its high viscosity, is sometimes used as an intra-articular injection for patients with OA. Hyaluronan is used to relieve knee pain due to OA. It may be considered for patients who do not get enough relief from simple painkillers such as paracetamol, NSAIDs, or from exercise and physiotherapy. The recommended dosage was one 2-ml injection once a week for three weeks (three injections per knee), but now Synvisc-One is given as a single 6 ml injection into the joint.
Other preparations are Euflexxa- one dose per week (3 total doses), Hyalgan- one dose per week (3 to 5 total doses), Orthovisc- one dose per week (3 to 4 total doses), and Supartz- one dose per week (5 total doses). The pain relief can last up to six months. Some people who have arthritis in both knees choose to have both done at the same time.
Hyaluronan is generally well tolerated. However, it may not work for everyone. Before trying Hyaluronan, tell Dr. Sukhbir Uppal if you are allergic to products from birds—such as feathers, eggs or poultry. Hyaluronan has not been tested in children, pregnant women or women who are nursing. You should tell your doctor if you think you are pregnant or if you are nursing a child.