While the Tin Man in The Wizard of Oz needed Dorothy to spritz him with oil to keep his joints working along their route to the Emerald City, these days orthopedic surgeons are providing a similar service for mild to moderate arthritis pain patients at Beaumont Health System.
This Beaumont lube job is being done by a series of injections to the effected joint. Whether people refer to these injections as "knee lube," or "chicken fat," the medical terminology is viscosupplementation. The injections are primarily made up of hyaluronic acid procured from chickens (rooster combs).
Hyaluronic acid is a naturally occurring substance found in normal joint fluid. It acts as a lubricant to enable bones to move smoothly over each other. Arthritic joints have less hyaluronic acid than normal joints and can often benefit from the use of these injections.
"I tell my patients that it's like a combination of oil, cushioning, vitamins, and anti-inflammatory medicine," says Joseph Guettler, M.D., Beaumont orthopedic surgeon. "It works best for mild to moderate arthritis in joints such as the knee, and it seems to work for a majority of patients. When it works, it can offer relief for six months to two years. It's not perfect, but it is another important weapon in our fight against arthritis."
Viscosupplementation has been available in the U.S. for more than 10 years and it's a good treatment approach for the arthritic knee, adds Dr. Guettler. He says it bridges a gap and "buys time" for patients who have tried other arthritis treatments and aren't to the point of needing knee replacement surgery.
During treatment, patients undergo a series of one to five injections; depending on the brand. Five of the most common commercial preparations are called Synvisc, Supartz, Hyalgan, Euflexxa, and Orthovisc. Most patients notice symptom improvement one to four weeks after injections begin.
And, like the Tin Man, this treatment gets many Beaumont patients back along their own "Yellow Brick Road."
|Model of knee joint shows cartilage area treated during viscosupplementation.