Hyaluronic Acid Injections

Designed specifically for deteriorated joints, hyaluronic acid (HA) injections help to provide lubrication, protection, and cushioning within the joint.

The knee joint is encased in a joint capsule filled with a viscous fluid, which coats the ends of the two bones in the knee to prevent friction when they rub against each other during activity. Hyaluronic acid (HA) is a natural fluid in all connective tissue and joints, which aids in decreasing friction during movement. Osteoarthritis is a result of friction in the joint. When the two ends of the joints rub against each other, it wears down the articular cartilage cushion between them and also decreases the body’s natural production of HA, the lubricant. Not only do you have friction, but the friction prevents the joint from making adequate lubricant, compounding an otherwise already degenerative issue.

One of the best solutions is to supplement the body’s natural lubricant with HA injections. HA can be synthesized in a lab to have a nearly identical molecular makeup as the natural HA made by your body, which can then be injected into your joint to renew and restore your joint fluid back to normal. This process is called viscosupplementation. Injections not only slow the progression of arthritis by reducing friction in the joint, but they can also help reduce the pain that comes from inflammation. Normally the improvement in joint health and pain relief lasts about six months until the synthetic HA breaks down and your body naturally absorbs it. We typically suggest receiving HA injections every six months to maintain the progression of arthritis and hopefully prevent or at the very least delay knee replacements.

Blind (or unguided) HA injections are the norm at most orthopedic clinics; however, this method of injection has only a 75% accuracy rate. The HA has to be injected directly into the joint capsule in order to be effective. The joint capsule is essentially impermeable, so nothing outside of the joint can cross the capsule membrane into the joint, meaning that any medication injected outside the joint by accident becomes ineffective. At ActiJoint, we used ultrasound-guided injections to provide 100% accuracy in ensuring that the medication makes it precisely within the joint capsule.

No allergic reactions have been reported by the FDA for HA injections since its approval and first uses in the 1990s. Our process is also done under completely sterile conditions, so the risk of infection is next to nothing. We have found ultrasound to be a superior guided instrument not only because of the ability to see soft tissue detail that x-rays miss, but also because it allows us to avoid radiation exposure and using contrast dye (which is highly allergic and can be toxic to the kidneys). This is one of the many aspects that sets The Active Joint Institute apart as a leading HA injection facility.

At ActiJoint, our goal is to make your injections as painless as possible. Before the injection, we spray the injection site with a topical anesthetic (ethyl chloride) to numb it and then inject lidocaine to numb the needle track. The guided injection is then administered with the smallest possible needle using an injection approach rated least painful. The same needle is then detached from the lidocaine syringe and connected to the one containing HA, so there is only ever one needle stick per joint. For those patients who desire even more comfort, nitrous oxide (laughing gas) is available during the procedure.

HA is covered by most insurances, so please call to schedule an appointment with us or ask one of our providers any questions you have.