Joint Fluid Therapy

Dr. Riggs talking with patient about joint fluid therapy.

Non-Surgical Joint Fluid Therapy in Portland, OR, Bellevue, WA, and Tempe, AZ

Conditions like osteoarthritis can cause chronic knee pain that make it difficult to stay active. Patients who have persistent or recurrent knee pain might benefit from a procedure called viscosupplementation. This treatment improves the quality of the joint fluid which provides a cushioning effect to protect cartilage tissue. 

At Reflex Knee Specialists, we use state-of-the-art technology to deliver effective non-invasive treatments to our patients. Reflex Knee Specialists has offices in Oregon, Washington, and Arizona. Learn more about the benefits of joint fluid therapy and what to expect during the treatment.

What Is Viscosupplementation?

Joint fluid therapy, also known as viscosupplementation or hyaluronic acid treatment, is a non-surgical treatment for pain caused by knee osteoarthritis. A synthetic gel is injected into the knee joint to reduce inflammation and increase mobility.

The injection contains supplemental hyaluronan (hyaluronic acid), a substance naturally found in the body. Hyaluronic acid lubricates the joint and creates protective cushioning over the cartilage in the knee. These injection treatments can improve mobility while reducing inflammation, pain and stiffness.

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Conditions Treated by Joint Fluid Therapy

Viscosupplementation is an FDA-approved treatment for patients with knee osteoarthritis (OA). Healthy joints have cartilage tissue that serves as a shock absorber between the bones. The knee joint also contains a gel-like substance called synovial fluid that lubricates the joints. Over the course of osteoarthritis (OA), cartilage is exposed to chronic inflammation which causes it to break down. Another effect of OA is that the joint lining (synovium) doesn’t produce as much synovial fluid and the quality of the synovial fluid deteriorates, which exacerbates damage to the cartilage tissue. Osteoarthritis (OA) is the most common cause of knee pain and will slowly destroy tissues inside the joint over time. Patients with OA often have symptoms that include:

  • Pain, swelling, and tenderness in the knees
  • Joint stiffness that is worse in the morning
  • Limited flexibility or range of motion
  • Sensation of clicking, grinding, or popping

OA affects about 80% of adults over the age of 55 and is more common among women than men. Arthritis cannot be reversed, but proactive treatment can help manage the symptoms and slow further joint damage.

Benefits of Joint Fluid Treatment

At Reflex Knee Specialists, patients receive a comprehensive knee evaluation on-site. Using diagnostic ultrasound technology, one of our providers will examine a patient’s knee joint and determine the best course of treatment. If they have osteoarthritis or another condition causing chronic knee pain that affects their ability to work or exercise, they may be a candidate for joint fluid therapy. Joint fluid treatment is:

  • Non-invasive: Viscosupplementation injections are non-surgical and can be completed in an outpatient setting at one of our locations.
  • Quick: Treatments take just a few minutes to complete, and unlike surgery, there’s little to no downtime afterward.
  • Effective: Viscosupplementation knee gel treatments provide more long-lasting pain relief than steroid injections
  • Cartilage Protection: repeated steroid injections have been shown to accelerate damage to cartilage and hasten the need for a total knee replacement (TKR). Joint fluid treatments with HA have been shown to reduce levels of inflammation inside the joint and slow the progression of cartilage damage, thereby extending the life of the joint.
  • Cumulative Effect: The effects of joint fluid treatments are cumulative, meaning that patients often experience longer-term pain relief and fewer symptoms after each treatment cycle.
  • Used for early intervention: When used to treat early cartilage deterioration – which can be detected by ultrasound assessment — joint fluid therapy can help reduce additional damage to the joint and add years of life to the joint.

Additionally, many patients find that they can reduce their usage of pain medications after a series of treatments.

Joint fluid therapy treatments are covered by Medicare and most insurance plans.

What to Expect at Your Appointment

Before recommending viscosupplementation, the team at Reflex Knee Specialists will perform a diagnostic knee ultrasound as part of a comprehensive evaluation to assess the condition of your knee(s). This is a non-invasive imaging test that uses sound waves to generate dynamic images of the tissues inside the knee joint. Unlike X-rays, an ultrasound doesn’t use ionizing radiation, so it’s safe for all patients. Ultrasound allows our providers to visualize the tendons, ligaments, meniscus, joint lining (synovium), and, most importantly, to check for any signs of cartilage damage.

At Reflex Knee Specialists, we provide joint fluid therapy on an outpatient basis. When patients arrive for their appointment, our medical team will help them get comfortably seated on a treatment chair. A provider will then clean and sterilize the knee area with an antiseptic solution.

The provider will use ultrasound technology to guide the needle into the correct location inside the joint to ensure the HA gel goes into the right location. Knee injections performed in other clinics usually do not use ultrasound guidance; research has shown that without guidance, the medication is not inside the joint up to 30% of the time. For this reason, 100% of joint fluid treatments at Reflex Knee Specialists are performed with ultrasound guidance to ensure proper delivery of the HA gel inside the joint capsule.

After the treatment, patients can go home or return to work, but it’s best to avoid strenuous exercise for 24 to 48 hours. A patient may have minor swelling, bruising, or redness at the injection site, and an ice pack will help alleviate any discomfort. The provider will provide specific instructions, but most patients can resume their normal activities right away.

Hyaluronic acid treatment can provide joint pain relief that lasts anywhere from four to six months. Some patients feel significant pain relief a month after their first series of injections, while it may take longer in others to see results. Supplemental hyaluronic acid treatments will reduce inflammation and pain and provide additional cushioning and protection to the cartilage tissue.

Most HA gel treatments are administered once a week for three to five weeks, depending on the amount of inflammation and damage present in your knee and what your provider recommends.

Our providers will create a customized treatment plan based on different factors, including age, overall health, and the severity of the symptoms. They will monitor a patient’s progress and adjust their treatment plan as needed. Most patients find that they only need to receive HA treatments once or twice a year to keep the inflammation and pain under control and allow them to remain active. 


Other Conservative Care Options

Many patients will receive viscosupplementation in combination with other treatments. At Reflex Knee Specialists, each patient receives personalized care. Treatment options may include:

Physical Therapy

A bio-mechanical assessment of the knee by a skilled physical therapist provides important information about the knee mechanics (if the knee is moving properly), as well as the condition of supporting structures above and below the knee. Subtle compensatory patterns often develop over time and can create problems with other joints such as the hips. The physical therapists at Reflex Knee Specialists have all undergone specialized training to identify and treat these dysfunctional patterns of movement. They will create a personalized physical therapy program with a combination of manual therapy and exercise in one-on-one sessions to help patients increase range of motion and to optimize knee movement and function.

Knee Bracing

Often, patients with osteoarthritis have knee instability and will benefit from an offloading knee brace. Wearing a brace helps restore proper alignment and correct compensation patterns. An offloading knee brace will also reduce the stress over an area of cartilage damage to help alleviate pain and reduce inflammation inside the joint. Providers at Reflex Knee Specialists will let you know if a brace is needed and help you find the brace that best fits your needs.

Ozone Joint Therapy

Ozone joint therapy involves an injection of ozone gas into the knee joint using ultrasound guidance. Injections of ozone can reduce inflammation and deactivate the proteins that break down cartilage tissue. There is a synergistic effect when ozone therapy is combined with hyaluronic acid (HA) treatments: patients who receive ozone with the HA treatments do better than those who receive HA treatments without ozone.

Lifestyle Changes

Healthy lifestyle behaviors include:

  • Exercising and stretching regularly
  • Eating an anti-inflammatory diet
  • Getting enough sleep
  • Maintaining a healthy weight

These practices can help patients manage chronic conditions like osteoarthritis.

Learn More About Joint Fluid Therapy at Reflex Knee Specialists

If you are experiencing recurrent knee pain or stiffness, joint fluid therapy may help. Regain your independence and start enjoying the activities you love again. Let the team at Reflex Knee Specialists perform a comprehensive evaluation to identify the underlying cause and formulate a treatment plan and help you lead a more active and fulfilling life.

Schedule a Consultation with a Knee Specialist Today

With locations in Portland, Oregon, Bellevue, Washington, and Tempe, Arizona Reflex Knee Specialists offers a wide range of innovative therapies that can help you move forward without surgical intervention. Our team includes board-certified physicians, nurse practitioners, physician assistants, and licensed physical therapists. To schedule your initial consultation, call us or contact us today.

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