Is Hyaluronic Acid An Effective Treatment For Osteoarthritis?

Hyaluronic acid is a clear jelly-like material that is found in many places in the body, including the synovial fluid of joints and the vitreous humor of the eyes. Hyaluronic acid acts as a binding, lubricating, and protective agent and may boost the shock-absorbing properties of a person's joints.

Recognizing hyaluronic acid's many functions in the body, scientists have looked for ways to use it to treat disease. Hyaluronic acid was first used in eye surgery to replace lost vitreous fluids. Today, it is used in plastic surgery to improve the appearance of scars and wrinkles. In this application, Restylane (the brand name for hyaluronic acid) is injected into the skin to “puff up” tissues.

Rheumatologists and orthopedic surgeons have used hyaluronic acid injections to treat the knees of people affected by OA, a type of treatment sometimes called viscosupplementation. The addition of this material to the joints provides a cushioning and lubrication effect. In addition, hyaluronic acid injections provide pain relief even after the medication is no longer detectable in the joint. These injections are an alternative to corticosteroid (“cortisone”) injections for people with knee pain that is not manageable with physical therapy and pills.

Hyaluronic acid is not absorbed through the skin, and it cannot be given orally because it is digested by stomach enzymes. Treatment for OA requires a weekly injection into the knee for three to five consecutive weeks, depending on the brand used and based on the doctor's judgment. This type of treatment has several advantages and disadvantages in comparison to cortisone injections.

The main advantage is that the pain relief it produces might last longer than the pain relief offered by a cortisone injection. Unfortunately, hyaluronic acid injections may take a little bit longer to work than cortisone injections, and this therapy requires a greater number of visits and injections. Finally, hyaluronic acid injections are much more expensive than cortisone injections. For this reason, hyaluronic acid is recommended primarily as a last alternative before pursuing surgery.

Recently, some placebo-based, controlled studies have cast doubt on the efficacy of hyaluronic acid injections. You should discuss the results of these studies with your doctor and decide whether this therapy is right for you.