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Osteoarthritis (OA) of the knee affects the bone, cartilage tissue, and the synovium of the knee, which surrounds the inner lining of the knee and creates synovial fluid which nourishes the knee joint. OA of the knee causes these components to lose function over time which leads to bone damage, pain, and stiffness.

Viscosupplementation is a medical procedure used to treat OA of the knee through hyaluronic acid injections. Hyaluronic acid is a natural substance that is a foundation of the synovial fluid in healthy knee joints but is sparse in osteoarthritic joints. In healthy joints, hyaluronic acid gives the joint fluid its thick, glue-like quality that enables the cartilage-covered bones to easily and painlessly glide against each other. Below is everything you need to know about the disease and get it properly treated.


As with many types of arthritis, osteoarthritis takes years to develop and progresses through 4 stages. These are the characteristics, symptoms, and treatments associated with each stage.

Stage 1 is mild and joints will appear normal on an X-ray. During this stage, osteophytes (small lumps of bone) may grow in the knee area and there may be slight damage to the cartilage. It is rare to be formally diagnosed with OA of the knee in this stage as symptoms are minimal.

Stage 2 is typically when a person begins to feel pain and doctors begin to notice signs of deterioration. Osteophytes are more pronounced, the cartilage begins to thin, and stiffness/pain will increase. Treatments include physical therapy and wearing a knee brace and/or shoe inserts to relieve the stress of the joint.

Stage 3 involves moderate damage with pain and discomfort may occur with daily activities.

Stage 4 is the most advanced stage of OA and the person will experience significant pain and discomfort when moving as well as constant inflammation.

Hyaluronic acid, a treatment heavily utilized here at Commonwealth Musculoskeletal medicine has been shown to be very effective in treating pain in patients with mild to moderate osteoarthritis.  


Hyaluronic acid injections in the knee are recommended when patients have exhausted all other treatments like wearing knee braces, avoiding activities that cause pain, and physical therapy.

The goal of viscosupplementation is to reduce pain, facilitate better knee movement, and can possibly offset OA progression. At Commonwealth, our treatments address multiple aspects of the disease. Viscosupplementation is followed by physical therapy to improve movement and build muscle support around the joint.

For accurate placement of the injection, the procedure is administered using fluoroscopy imaging which uses X-rays to capture real-time moving images of the inside of the target area. This allows our physicians to see the exact point where the injected material is administered in the knee. Learn more about the procedure here and if viscosupplementation sounds right for you, request an appointment.

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