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Ultrasound Guided Biologic Injections

Image guided injections are usually recommended if swollen or painful joints, tendons or ligaments have not responded to conservative treatments. These injections deliver medication directly into the joint and are beneficial in the treatment of osteoarthritis. They are temporary and safe methods to provide pain relief.

Hyaluronic acid acts like a lubricant within the joint to ease pain caused by the bones rubbing against each other. The effects of these medications are temporary and hence the accurate delivery using image guidance helps prolong the effects of the medications.

An image guided joint injection usually takes no more than 30 minutes and you can usually return home the same day. You will be awake during the procedure. The skin over the area is anesthetized. Your doctor may use either an ultrasound or CT scan to accurately guide the needle to the area needing treatment and the medication is then delivered. You may have to wait for some time in the recovery area to ensure there are no adverse effects.

You may feel slight pain at the injection site that can be resolved with over-the-counter pain medication. Other side effects of the injection may include bleeding, infection, numbness and weakness.

Hyaluronate injections

In order for joints to move smoothly they must contain an adequate amount of synovial fluid, which acts as a lubricant and shock absorber. Osteoarthritis causes synovial fluid to lose its properties by depletion of a component called hyaluronan. This leads to loss of cartilage and painful rubbing of the bones in the joints. A gel-like form of hyaluronan called hyaluronates or hyaluronic acid may be prepared and injected into the joints to increase their lubricating and shock-absorbing properties. Hyaluronate injections can relieve pain, improve mobility and delay the need for surgery.

Hyaluronate injections are usually performed after other non-surgical treatments for osteoarthritis such as medications, physical therapy and steroid injections have failed.

The procedure, also called viscosupplementation, first involves removal of any excess joint fluid with a syringe. Hyaluronates are then injected into the joint. Immediately following the injection, you may experience pain, swelling and warmth, which can be eased by ice applications. Avoid weight-bearing or strenuous activity involving the joint for the next 48 hours. The pain and swelling from osteoarthritis is gradually relieved with effects lasting for several months. A single dose or a total of 3 separate doses over several weeks may be required for optimum benefits.

Complications are rare but occasionally an allergic reaction may develop, intensifying symptoms.

Useful Links

  • the American Academy of Orthopaedic Surgeons
  • Mid America Orthopaedic Association
  • American Orthopaedic Society for Sports Medicine
  • American Association of Nurse Anesthetists
  • A Nation in Motion

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