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Research
into degenerative joint disease is progressing at a breakneck
pace. New and
improved treatment options are coming out several times a year.
Degenerative joint disease (DJD), also known as
osteoarthritis (OA), is one of the most common reasons people
see their family physician or orthopaedic surgeon.
Doctors are constantly coming up with more effective and
less invasive ways to treat this problem.
DJD
is “wear and tear” disease that most commonly effects the
hands and weight bearing joints of the body.
Essentially as the disease progresses, the cartilage that
serves to cushion the joint and help it glide degenerates.
This leads to increased friction within the joint,
inflammation, pain, stiffness, and deformity.
DJD
is an exceedingly common problem that affects literally millions
of Americans. Of
those affected, the knee is one of the most frequently involved
joints. Some of the
mainstay treatments for treating knee OA have been oral
anti-inflammatory medicines, steroid injections into the knee,
and total knee replacements.
Although all of the treatments listed above are
themselves improving, there is another treatment which, though
widely used and thoroughly tested, is much newer.
This new drug is called Hyalgan, it’s competitor is
Synvisc.
Hyalgan is a compound that is very
similar to the natural fluid produced by joints.
A physician injects it directly into the knee joint.
Hyalgan can be used alone or in combination with other
osteoarthritis therapies. In
fact, it has been shown that it is more effective when used
concurrently with NSAID medicines.
Hyalgan works in several different ways.
First, it increases the viscoelasticity of the joint.
This means that after completion of the Hyalgan therapy,
the knee should glide much easier through its range of motion.
Secondly, it seems to stimulate the joint to produce
endogenous synovial fluid.
Like its artificial counterpart, this helps to lubricate
and cushion the joint. Hyalgan
also seems to inhibit some of the enzymes within the joint that
cause the breakdown of cartilage.
By doing this, it may delay or eliminate the need for a
more invasive therapy. Finally,
Hyalgan seems to at least partially inhibit the inflammatory
response within the knee. This
is the same effect as oral medicines and as intra-articular
steroids.
Several
recent studies have demonstrated the efficacy of Hyalgan.
One showed that 68% of people noticed significant
improvement in their symptoms even as far out as 26 weeks when
compared to a placebo. In
another study, researchers injected Hyalgan into one group and
steroid into another. After
a short time to allow the therapy to work, they looked inside
the knee with a camera. When
compared both visually and pathologically, the improvements
noticed with Hyalgan were similar to ones gained from the
steroid shot.
Hyalgan is very safe.
It has been used worldwide for more than 12 years and
over five million injections have been given.
The occurrence of side effects is very minimal.
Occasionally, patients may develop a small skin
irritation or infection. Also,
in extremely rare cases, they may develop a joint infection.
Treatment
with Hyalgan involves a series of weekly joint injections over
three weeks. The
injections are generally very well tolerated.
Also, treatment with Hyalgan does not preclude someone
from also receiving an occasional steroid injection into the
knee.
If
you have osteoarthritis of the knee, talk to your doctor to see
if you might be a good candidate for Hyalgan therapy.
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