Imagine your joints are like hinges. Synovial fluid is the lubricant that causes the hinges (the bones and cartilage) to move smoothly without sticking. Without it there can be friction leading to pain and inflammation. Are there any benefits for post-operative synovial fluid replacement following knee surgery?
What is synovial fluid replacement?
Synovial fluid is secreted by the lining of the synovial joint.
One of its main components is Hylauronic Acid, which gives the fluid its essential viscosity and elasticity. As we age our synovial fluid can start to thin, giving rise to painful conditions like Osteoarthritis. Combined with the wearing away of cartilage, which also occurs with age, this can cause joints to become swollen, painful and stiff.
Synovial Fluid Replacement, also known as viscosupplementation, is a treatment to restore the viscosity of synovial fluid. Hylauronic Acid , is injected directly into the knee joint which not only supplements the body’s own dwindling supplies but also stimulates the joint linings to begin producing it by themselves.
How does synovial fluid replacement work?
The treatment is usually repeated once a week for three to five weeks, depending on the severity of Osteoarthritis and the brand of Hylauronic Acid injection being used. It has been shown to stop and even reverse the degenerating process of Osteoarthritis.
The treatment is not painful and has very few side-effects. The fact that the Hylauronic Acid is derived from chickens means that the treatment is unsuitable for people with an intolerance to chicken and/or eggs. But, this apart, Synovial Fluid Replacement is proving to be an effective and safe treatment for Osteoarthritis.
It also has a role to play in promoting recovery from arthroscopic knee surgery.
In this case doctors replace the body’s own synovial fluid with a synthetic version to reduce pain and swelling. Traditionally, local anaesthetic is injected into the joint to bring down pain and swelling but this can damage cartilage. Replacing the synovial fluid has been found to have similar effects but without the harmful side-effects.
Sanjeev Anand, consultant orthopaedic surgeon at Nuffield Health Leeds and Leeds Teaching Hospitals NHS Trust carried out a study to determine whether replacing this treatment would improve outcomes for patients. His findings, published in The Journal of Knee Surgery, showed that replacing synovial fluid with a synthetic replacement called Viscoseal® which was injected into the joint in place of local anaesthetic, produced a significant reduction in swelling, pain and the need for analgesia.
More research is needed in this area but early indications suggest that synovial fluid – whether natural or synthetic – has a key role to play in restoring joint function and enabling people to lead a full and active life post-knee surgery.