Ben Yates Consultant Podiatric Surgeon
Wiltshire
Foot Surgery Services
Mr Ben Yates
Consultant Podiatric Surgeon
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Hyaluronic Acid Injections
Joints are like gears – they work best if they are well lubricated. In a healthy joint, a thick substance called synovial fluid provides lubrication, allowing bones to glide against one another. Synovial fluid acts as a shock absorber, too. In people with osteoarthritis, a critical substance in synovial fluid known as hyaluronic acid breaks down. Loss of hyaluronic acid appears to contribute to joint pain and stiffness.
 
Hyaluronic acid injections are one treatment option to consider to help reduce the pain and stiffness of an arthritic joint. Most studies of hyaluronic acid injections have involved the knee joint. There is now growing evidence of their use for foot and ankle joint arthritis.
 
How successful are hyaluronic acid injections?
About 30 percent of people who undergo hyaluronic acid injections become virtually pain free, and symptom relief may last up to two years. Unfortunately another 20 percent of patients experience no benefit at all. It is currently not possible to predict who is going to have an outstanding response versus a modest response versus no response at all. One of the main benefits of injections of hyaluronic acid over cortisone is that repeated injections of hyaluronic acid cause no long-term damage to the joint or soft tissues which is not the case with multiple cortisone injections. This means that this treatment can be repeated many times if required over many years.
 
How does it work?
Hyaluronic acid may act as a lubricant and shock absorber. Hyaluronic acid also has other functions in the joint such as reducing inflammation by interfere with prostaglandins and cytokines (naturally occurring compounds that promote inflammation). Injecting hyaluronic acid may coax the joint into increasing its own production of this important substance, which may in turn help to preserve cartilage.
 
What to expect from an injection?
You can drive to and from your appointment. The injection is administered under aseptic technique. It is recommended that you do not strain your joint for two days after receiving the injection and avoid activities such as sports, heavy lifting, or prolonged standing on your feet.
Temporary pain or swelling in the joint may occur after receiving hyaluronic acid injection.
It takes about five weeks, on average, before a patient experiences the full benefits of hyaluronic acid. Large research reviews found that the pain-relieving benefits of hyaluronic acid occur at peak levels about three months after the injection.
 
Side effects:
Pain in the injected joint
Swelling or redness in the joint
Less common;
Blistering, discoloration of the skin, feeling of pressure, hives, itching, lumps, numbness, pain, rash, redness, or warmth at the injection site.
    
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