Osteoarthritis and Hyaluronan

Physiotherapy and Sports Injury Clinic based in E9, London

Osteoarthritis and Hyaluronan and Hyaluronic acid injections

Osteoarthritis is a chronic disease process affecting the joints. The large weight bearing knee and hip joints are the most frequently affected. Osteoarthritis is one of the leading causes of pain and disability worldwide and is particularly common with increasing age but can also occur in younger patients, commonly because of previous joint trauma through sport or injury.

The pathophysiological process is not fully understood but includes changes in the articular cartilage, the synovium and synovial fluid, subchondral bone and the joint capsule. The result can be varying degrees of joint pain, stiffness, laxity and instability, swelling, functional limitation and reduced quality of life.

Osteoarthritis of the knee joint: a) Grade 2, b) Grade 3

Steroid injections are able to suppress inflammation and have been shown to provide a significant reduction in osteoarthritic knee pain as soon as 1 week after injection, with the effect lasting up to 3 months.

An alternative to steroid injection is injection with a Hyaluronan (Hyaluronic acid injection) which is a naturally occurring substance widely distributed throughout the body including the joints. The presence of Hyaluronan in joints is essential for normal joint function. Its viscous properties can help to facilitate the cushioning and lubricating characteristics of the joint during movement. The ability of Hyaluronan (Hyaluronic acid injections) in helping to control the symptoms of osteoarthritis in some patients is supported by recent evidence (www.versusarthritis.org/news)

Our clinic uses a form of Hyaluronan called Ostenil (www.trbchemedica.co.uk) which can be given up to 3 injections at weekly intervals. In contrast to steroids Ostenil seems to have a slightly delayed onset with effect being noted at 2-5 weeks following injection.

Maximum effect occurs by 1-2 months, but efficacy can extend from between 4 months to 1 year.

An analysis of 76 clinical studies of Hyaluronan injection concluded that this therapy is safe and effective in patients with knee osteoarthritis. Ostenil has been used in our clinic for a number of years with no significant side-effects and demonstrated a good outcome in a recent study carried out in our clinic.

For more information on the conditions we treat and services we offer, or to book an appointment please call 020 8510 5751 or email us at p.resteghini@nhs.net

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