{"id":559,"date":"2016-09-27T14:44:29","date_gmt":"2016-09-27T14:44:29","guid":{"rendered":"http:\/\/stadiasportsmedicine.com\/info\/?p=559"},"modified":"2017-09-26T14:33:14","modified_gmt":"2017-09-26T14:33:14","slug":"hyaluran-injections-an-approach-to-arthritis-treatment-in-des-moines-ia","status":"publish","type":"post","link":"https:\/\/stadiasportsmedicine.com\/info\/2016\/hyaluran-injections-an-approach-to-arthritis-treatment-in-des-moines-ia\/","title":{"rendered":"Hyaluran Injections: An Approach to Arthritis Treatment in Des Moines, IA"},"content":{"rendered":"<p><strong>What are hyalurans?<\/strong> Hyalurans are naturally occurring substances in the synovial fluid of joints that essentially serve as joint lubricants, reducing friction and excessive bone wear and tear.\u00a0 In osteoarthritis, this natural lubricant starts to thin out and work ineffectively.\u00a0 One approach to arthritis treatment is to inject hyalurans into the knee in an effort to temporarily restore this cushioning effect.\u00a0 Hyaluran injection can result in relief of arthritis pain that typically lasts for about six months, but can last as long as a year.\u00a0 The first hyaluran introduced to the U.S. market back in the mid-1990\u2019s was Hyalgan \u2013 a five injection series over five weeks!\u00a0 Most series since then involve three injections over three weeks.\u00a0 One product has now been available for several years as a single injection.<\/p>\n<p><strong>Does insurance pay for this treatment? <\/strong>Most plans cover a series of hyaluran every 3-6 months for patients with documented osteoarthritis of the knee.\u00a0 It is not considered a covered benefit for arthritis of other joints.<\/p>\n<p><strong>Do hyalurans work? <\/strong>Studies looking at the effectiveness of hyaluran treatments are mixed, with some showing benefit and others showing little treatment effect.\u00a0 Anecdotally, there is no question that some patients in our office with symptomatic osteoarthritis of the knee do get relief from these injections, returning periodically for a repeat shot when their symptoms return.\u00a0 There is really no way of knowing if a patient with arthritis will respond to injection of hyaluran until it\u2019s been tried.<\/p>\n<p><strong>Are hyalurans potentially effective for arthritis in other joints? <\/strong>The vast majority of hyaluran injections are done on the knee, and there isn\u2019t enough information to be able to say one way or another whether these injections are effective for osteoarthritis in other joints.\u00a0 Having said that, there is little risk from injecting, for example, an arthritic hip or ankle, and it theoretically could be beneficial, since the disease process is often similar.\u00a0 Hyalurans are only FDA approved for use in the knee, however, so injections into other joints would not be covered and the cost for the procedure would fall to the patient.\u00a0 Typically, this could run from about $250 for small joints to as much as $850<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-564\" title=\"Hyaluran Injections\" src=\"http:\/\/stadiasportsmedicine.com\/info\/wp-content\/uploads\/2016\/09\/Hyaluran-Injections-300x300.png\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/stadiasportsmedicine.com\/info\/wp-content\/uploads\/2016\/09\/Hyaluran-Injections-300x300.png 300w, https:\/\/stadiasportsmedicine.com\/info\/wp-content\/uploads\/2016\/09\/Hyaluran-Injections-150x150.png 150w, https:\/\/stadiasportsmedicine.com\/info\/wp-content\/uploads\/2016\/09\/Hyaluran-Injections-1024x1024.png 1024w, https:\/\/stadiasportsmedicine.com\/info\/wp-content\/uploads\/2016\/09\/Hyaluran-Injections-100x100.png 100w, https:\/\/stadiasportsmedicine.com\/info\/wp-content\/uploads\/2016\/09\/Hyaluran-Injections.png 1080w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>for a hip (more product required).<\/p>\n<p><strong>What would I experience if I go to Stadia for hyaluran injections?<\/strong><\/p>\n<ul>\n<li>First, we would confirm with the patient what they would like injected.\u00a0 The three injection series that we use is Orthovisc.\u00a0 The advantage to Orthovisc is that there is a very low rate of allergic reactions to the product because of the way that it is made.\u00a0 The disadvantage is that the treatment involves three injections over three weeks.\u00a0 The one injection option is Synvisc One.\u00a0 Synvisc One carries a 1-2% risk of an allergic reaction that can cause a temporary uncomfortable swelling in the knee.\u00a0 If this occurs, the fluid can be easily drawn off.\u00a0 The advantage, of course, is that 98-99% of the time, it is a one shot treatment.<\/li>\n<li>Typically, we will use ultrasound guidance for your injection under the following circumstances:\n<ul>\n<li>If the leg being injected is large enough that surface landmarks are difficult to identify.<\/li>\n<li>If Synvisc One is being used.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>The reason for use of guidance is to ensure entry into the joint.\u00a0 For a joint as large as the knee, one might think that it would never be missed, but medial studies that have looked at the success rate for knee injections in an outpatient orthopedic setting show that the knee is missed about 20-25% of the time.\u00a0 Thus, it is reasonable to do a three injection series blindly (assuming normal leg girth), since there is a high statistical probability that the joint will be successfully entered at least 2\/3 times.\u00a0 For a single injection treatment that won\u2019t be authorized again by an insurer for 3-6 months, it is our opinion that it is best to use guidance to ensure 100% accuracy of placement.<\/p>\n<ul>\n<li>Our usual procedure for any injection at Stadia is to numb the area where the injection will occur with a small amount of local anesthetic using a very tiny needle.\u00a0 We also spray a cooling agent on the skin prior to the numbing injection so that the patient feels virtually no pain.\u00a0 One the patient is adequately numbed, the area is re-cleansed and the actual injection carried out, with or without guidance technology.\u00a0 This results in a procedure that is as comfortable for the patient as possible \u2013 one of our goals.\u00a0 Most patients are quite surprised at how painless these procedures actually are.<\/li>\n<li>Patient instructions after hyaluran injection are simply to maintain routine activity and to monitor symptoms for trends in improvement.\u00a0 Typically, a reduction in pain begins within 7-10 days.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>What are hyalurans? Hyalurans are naturally occurring substances in the synovial fluid of joints that essentially serve as joint lubricants, [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":564,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10,1,9,107],"tags":[104,118,119],"class_list":["post-559","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-athletes-patients","category-general","category-physicians","category-services","tag-arthritis","tag-hyaluran","tag-injection"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts\/559","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/comments?post=559"}],"version-history":[{"count":7,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts\/559\/revisions"}],"predecessor-version":[{"id":563,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts\/559\/revisions\/563"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/media\/564"}],"wp:attachment":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/media?parent=559"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/categories?post=559"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/tags?post=559"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}