Call us directly: 1-888-826-1660 714-285-0014

902 N. Grand, Santa Ana, CA 92701: View Location

Visco Supplementation

What is Visco Supplementation?

Visco supplementation is a medical procedure during which lubricating fluid is injected into a joint. Also called hyaluronic acid injections or hyaluronanic injections, visco supplementation is most commonly used to treat symptoms of symptoms of knee osteoarthritis.

By adding hyaluronic acid to the existing joint fluid of an osteoarthritic knee, the goal is to:

  • Facilitate better knee movement
  • Reduce pain
  • Slow osteoarthritis progression

Typical candidates for visco supplementation are people with knee osteoarthritis who have failed to improve with other non-surgical treatments.Following the injections, it is generally recommended that patients engage in a rehabilitation program that includes gentle, progressive knee exercise. The goals of rehabilitation are to improve range of motion and develop muscle strength to support the knee.

How does Visco Supplementation work?

During visco supplementation a small amount of hyaluronic acid, often just 2 mL, is injected directly into a joint capsule.A healthy knee joint has up to 4 mL of joint fluid within the joint capsule.1,2 Hyaluronic acid is a key component of the joint fluid. It gives the joint fluid its viscous, slippery quality, which does the following:

  • Enables the bones’ cartilage-covered surfaces to glide against each other, thereby reducing joint friction
  • Adds cushion to protect joints during impact (e.g. weight-bearing activity)

Joints affected by osteoarthritis typically have a lower concentration of hyaluronic acid in their joint fluid than healthy joints, and therefore less protection against joint friction and impact. Experts believe this further accelerates the joint degeneration process, setting in place a vicious cycle.

As its name implies, viscosupplementation artificially supplements the joint fluid’s natural viscosity. By injecting a man-made hyaluronan into the knee, doctors hope to temporarily lubricate the knee joint, thereby decreasing pain improving function and perhaps even slowing the degeneration process.

Can I have visco supplementation in another area than my knee? 

The United States FDA has approved viscosupplementation for treating knee arthritis only, but treating hip osteoarthritis or other joints with viscosupplementation is permitted. Some doctors have found some patients respond to viscosupplementation for the hip, shoulder and ankle, but there is relatively little published research regarding its efficacy.

Using visco supplementation for a joint other than the knee is considered an “off label” use of the injectable fluid. Insurance companies may consider the procedure “experimental” and not cover the cost, so patients should check with their insurance companies if considering visco supplementation for hips or other joints.

How long will I have pain relief?

When successful, visco supplementation can provide knee osteoarthritis pain relief for 3 months or even a year, with the greatest pain relief typically found between 5 and 13 weeks.

While visco supplementation works for some knee osteoarthritis patients, it is not a surefire treatment for everyone.

What happens during the procedure? 

Visco supplementation is an in-office procedure that usually takes less than 5 minutes:

  • The patient lies on his or her back, with the knee either straight or bent at a 20- or 30-degree angle. If Dr. Moheimani prefers the knee bent, a rolled up towel may be placed under the knee to prop it up at the proper angle.
  • The knee will wiped down with disinfectant such as alcohol or iodine.
  • The patient will be asked to relax the leg muscles; this will facilitate a successful injection and also can make the injection less painful.
  • If ultrasound is being used, a gel will be applied to small area of skin near the injection site, and a technician will gently press a hand-held ultrasound transducer against the gel-covered skin. An image of the joint space will be projected onscreen for the doctor to see.
  • Dr. Moheimani may administer a local anesthetic, such as lidocaine, to numb the area.
  • If the knee is swollen with excess fluid, the doctor may aspirate (draw out) this fluid with a needle and syringe.
  • Using a new syringe, Dr. Moheimani will inject a small amount (often just 2 mL) of hyaluronan, or hyaluronic acid, on one side of the kneecap.
  • The injection area is cleaned and bandaged.
  • The patient will be told to straighten and bend the knee several times to help spread the hyaluronate throughout the knee joint.

Follow us on social media: