Granny’s complaint, rheumatism and old bones are just a few examples of the common vernacular terms for arthritis.  Most people are intimately familiar with this disease because they either have it themselves or know someone who does.  So common is the condition that most people arrive at a diagnosis prior to seeing their doctor.  That said, there are innumerable nuiances associated with the diagnosis and treatment of arthritis, many of which are relatively new innovations.

Before embarking on a discussion of the latest therapy, it is probably a good idea to have a brief overview of arthritis.

Lets begin by saying that there are many different types of arthritis including osteoarthritis (OA), rheumatoid arthritis, gouty arthritis, traumatic arthritis and so on.  By far and away, the most common variety of arthritis is OA.

The Centers for Disease Control estimate that there are 37.9 million Americans living with OA of the knee.  This totals approximately 15% of the US population.  Of these, an estimated 7.9 million identify OA as a major or contributing cause of activity limitation.

OA results from a time related degeneration of the joint and its components.  This is evident in the other name for OA, degenerative joint disease.

Most patients with OA do not attribute their condition to a single traumatic event.  Rather, their disease results from a life time of use and sometimes abuse of their bones and joints.  Traumatic events can sometimes precipitate or accentuate OA, but the etiology of the disease is a generalized wear and tear of the joint.

The symptoms of OA are familiar to most of us and include pain in the affected joint, stiffness, and loss of range-of-motion.  Clinically, there is usually a narrowing of the joint space due to loss of cartilage in the joint.  The cartilage that is left can appear frayed and ragged.

Healthy knee joints contain joint (synovial) fluid that serves several purposes.  First, it serves to nourish the structures within the joint.  The fluid also serves to lubricate and cushion the cartilage and bone within the joint.  It can be though of as the motor oil of the joints.

In the arthritic joint, the synovial fluid is often polluted with mediators of inflammation.  It can also be quite thin and watery (hypoviscous)  This can contriubte markedly to the discomfort and immobility that arthritis patients suffer from.

Standard treatment regimens for OA have included non-steroidal anti-inflammatory medications, steroid injections into the joint, physical therapy, braces, creams and joint replacement therapy.  Now, orthopaedists have another tool at their disposal for the treatment of OA.

This new therapy is called Hyalgan.  Hyalgan is a synthetic joint fluid made up of large viscous macromolecules suspended in solution.  Hyalgan therapy involves a series of five injections into the knee joint over a period of weeks.

Initial and subsequent clinical data suggest that Hyalgan therapy is quite effective in relieving many of the symptoms of arthritis in selected patients.  Most patients report significant improvement in the short, intermediate and somewhat long term.

The goal of Hyalgan therapy is to relieve much of the pain and stiffness associated with arthritis.  The duration of relief varies with the severity of disease and the individual patient, but symptoms may be eased anywhere from weeks to years.