Knee Arthritis|Knock Knees|Virtual Knee Surgery

Osteoarthritis, the commonest form of arthritis affects the knee joint most often in India. Elderly afflicted by this chronic painful disease need joint replacements as a permanent solution to improve their quality of life and put an end to disabling pain. However it is increasingly common to see many young people also suffer from the earlier manifestations of the disease. In this group alternate solutions have to be recommended considering the age, increased demands like participation in sports and work. Joint replacements cannot obviously be a solution to young men and women.

Osteoarthritis is a age related wear of Articular cartilage which covers the end of the long bones in a joint. It is smooth, elastic, shining tissue. It is responsible for lubrication, shock absorption, and pain-free movements. Unlike other tissues of the body, it has limited capability of regeneration and repair as it has no blood supply and nerve supply. This limited repair capacity decreases with aging and leads to depletion in the arthritis knee. Pain and stiffness ensue, necessitating medication or surgery.

Osteoarthritis does not involve the whole of the joint to begin with. A localized area of cartilage damage called a lesion is the precursor and harbinger of the disease. If left untreated, lesions greater than 1. 5 cm will lead to arthritis after 15 years.

Some generalized and local conditions predispose to early cartilage damage. These are mechanical, chemical, and biological. Occupations, Obesity, mal-alignment or structural damage can predispose to cartilage damage.

Ligaments and menisci stabilize the knee. Menisci dissipate stresses, help in lubrication, increase joint conformity and confer additional stability. The ligaments inside the joint are called the cruciate ligaments. These are torn in many sports, or two wheeler accidents. An ACL injury is the commonest ligamentous injury. Unrepaired ACL's lead to further tearing of the menisci and both in association can lead to osteo-arthritis.

Meniscal tears can occur in isolation in sports or domestic accidents. After the importance of the menisci was realized and arthroscopic surgery came into vogue, attempts are made to resect and remove only the damaged portion of the menisci and preserve the rest. However, it is not always possible to do so as the damage is beyond repair and a total or subtotal Menisectomy is necessary. Such knees are also predisposed to develop secondary osteoarthritis (occurring in younger persons at an earlier age) cf Primary osteoarthritis which occurs in the elderly.

Some people have deformities around the knee. These may be situated in the thigh bone or leg bone. Normally in the standing position, there should be no gap between the inner side of the knee and ankle joint. If a gap exists between the knees, then the person has bow legs (Genu varum) and if a gap exists between the ankles, then the legs diverge at the ankle, causing knock knees (Genu valgum). Both these deformities can lead to one sided wear of the knee joint and arthritis in one half of the knee.

Surgical solutions are available to prevent or treat early arthritis. These alternatives avoid knee pain from arthritis.

These knee reconstructive procedures attempt to restore the anatomy of the joint and are mainly of a biological nature. They do not involve joint replacement. Examples are

1) Knee ligament reconstruction- ACL reconstruction is possible through tiny key-hole incisions (arthroscopic surgery). Graft is taken from the patient's own body (autograft) or from a brain dead person, (allograft). This tendon graft is threaded through bony tunnels in the leg and thigh bones and is fixed with screws, buttons or other devices.

2) Meniscal suture- This is a procedure in which attempt is made to suture a torn meniscus if situated in a suitable position. Concomitant ACL reconstruction is required if there is an injury to this ligament also. This is done through arthroscopic surgery.

3) Meniscal transplant- This procedure is to be introduced shortly. In this menisci are harvested from the knee joints of brain dead living donors or non heart beating donors. These are preserved and then grafted into the damaged knee.

4) Reparative cartilage procedure are available to salvage localised cartilage defects and prevent their progression to extensive involvement. These are microfracture wherein small holes are made in the raw area to generate a super clot and in growth of fibro cartilage. In mosaicplasty, cartilage plugs are harvested from non weight bearing portion of the knee and re-implanted into the lesions.

5) Corrective osteotomy- Mal-aligned joints can be corrected by an osteotomy (division of bone). After this surgery, stresses across a joint are distributed more evenly excess wear from one half of the joint is minmized. This again prevent rapid progression of osteoarthritis and can postpone the need for a replacement.

These surgical alternatives are available in Chennai to treat painful knees in young people and prevent progression to arthritis. By availing these alternate surgical procedures where one is indicated, one can preserve and continue with natural cartilage and postpone or avoid joint replacement by a decade or more.

The total knee replacement (or arthroplasty) is a very common operation and brings great relief to many sufferers of osteoarthritis. A patellofemoral replacement is a much less common procedure and because of this is more difficult to find information on.

Osteoarthritis is a degenerative joint disease characterized by the loss of articular cartilage and resulting in pain and deformity. The knee is a very common site for osteoarthritis. As this type of arthritis is typical in weight bearing joints, it is most common in the knee between the tibia (shin bone)and the femur (thigh bone). It is not unusual for there to be coinciding patellofemoral arthritic changes when the weight bearing surfaces are worn. This is why the patellofemoral joint is frequently replaced at the same time as the tibiofemoral joint.

What is more unusual is the isolated patellofemoral joint replacement. This is the joint between the femur and the patella (kneecap). It is unusual because the joint is considered minimally weight bearing and as such is usually less affected by years of use. This is why patellofemoral replacements are usually the result of a previous significant event such as a fracture or a long term anatomical difference. This is the reason the main weight bearing surfaces are intact in these cases.

In fitting with modern surgical practice, a patellofemoral replacement only replaces the affected areas. The prostheses used are very different from the traditional total knee replacements. The back surface of the kneecap is replaced along with the groove at the front of the femur, and that is all.

The rehabilitation following the surgery is basically the same as that of a total knee replacement. The time in hospital is often less however as there is less significant bony disruption and potentially less pain.

Because isolated patellofemoral osteoarthritis is usually the result of trauma, those undergoing a replacement tend to be younger. For this reason they have higher physical expectations of their replaced knee and they may not last as long as they would in a more elderly patient.

When health professionals talk of prosthesis failure the usual cause is prosthesis loosening. The materials used today are very resilient and it is not the replacement that usually fails but the junction between the replacement and the bone itself.

One of the key benefits of the patellofemoral replacement is that it does not significantly affect any future total knee replacements. This means that it can be performed in relatively young people and delay the need for total knee arthroplasty.

The ability to operate on younger people adds an extra step in the treatment chain and can result in osteoarthritis sufferers experiencing much less pain in the lead up to a total knee replacement.

The usual recommendations for arthritis sufferers still remain:

Lose Weight if possible
Increase exercise levels
Gain Quadriceps strength
Take appropriate analgesia

Patellofemoral osteoarthritis can be a life changing condition. It is always wise to investigate all non surgical options before going down the surgical route. If you have honestly done everything you can to hold back the pain of patellofemoral arthritis but have been unable to manage it, discuss the surgical options with your Consultant. They will let you know if you are suitable for this kind of surgery.

Approximately 30,000,000 individuals in the United States suffer from arthritis. When it comes to arthritis in the knee, the vast majority is the wear and tear variety, which is known as osteoarthritis. Non-surgical knee arthritis treatments are typically very effective and one of the best that we have has been injections into the knee.

There are two different types of knee injections that are common. The first involves injections of cortisone, which is commonly known as a steroid. These may work well for a few weeks and a few months, and then may be repeated a few times a year.

Cortisone injections are a hefty anti-inflammatory. We know that knee arthritis involves a significant amount of inflammation, because these injections tend to work very well. From that standpoint, the injections work well. but they do not alter the course of the disease. They merely work exceptionally well for pain management.

It is unclear whether steroid injections have a deleterious effect on the cartilage itself. Numerous animal studies show this to be the case, but it has not been proven in humans. So for now they remain the gold standard for nonoperative injections in an attempt to avoid surgery.

Approximately a decade ago, an injection material was developed involving hyaluronic acid. Hyaluronic acid is a significant component of native joint fluid, and acts to protect and lubricate the joint surfaces. The material developed for human injection is not made from human hyaluronic acid, rather, it's developed from rooster combs.

Injecting hyaluronic acid into a person's knee can alleviate pain and help a person's knee start to make more of the lubricating fluid. Studies performed looking at hyaluronic acid injections into the knee have shown satisfactory results, over 65% good to excellent at the one year point.

There have also been research studies comparing steroid injections to hyaluronic acid, and those have shown equivalent pain relief. Both worked well in those studies, just no different in the amount and length of pain relief.

In addition, there appear to be no difference so far in the pain relief achieved from the varieties of HA injections available on the market. There is one called Hyalgan, and another named Synvisc. Both work well, and involve typically a series of 3 to 5 injections over a period of a few weeks. Others exist as well, and there is a new one involving a one time injection of HA.

The risks of the HA injections are not significantly different from steroid injections. This involves a small risk of infection, and another risk they won't work at all in patients. One additional risk seen in HA injections is called a pseudo-infection. This is where a person's knee looks infected, but it really isn't.

Overall, HA and steroid injections work well for nonoperative pain relief. It's not clear whether steroid injections need to be used first. More research is necessary to know for certain on that.

Osteoarthritis (OA) is the most common form of arthritis and affects approximately 28 million Americans. While it was initially viewed as a "wear and tear" phenomenon, it has become quite clear that it is a disease that is multifactorial in its development.

It is not a benign disease because, in addition to the pain, OA leads to functional disability as well as interference with activities of daily living. Eventually, though, it is the pain that brings the patient to the physician.

The joint is a dynamic structure where anabolic (building) activities are counterbalanced by catabolic (destructive) activities.

With OA, the catabolic activities gradually overtake the anabolic ones. While there are attempts at repair, these attempts are dysfunctional, leading to the formation of bony spurs, called osteophytes.

There are three major risk factors for the development of osteoarthritis. They are genetic (usually a family history is prominent), constitutional (obesity in the case of OA of the knee, and aging), and finally local components (injury, ligamentous laxity, congenital abnormalities).

The development of osteoarthritis starts with an initial injury to cartilage. Cartilage consists of cells called chondrocytes that sit inside a "soup", a matrix, which consists of collagen and proteoglycans.

The injury may trigger an inflammatory response leading to the synthesis of cartilage matrix degrading enzymes, produced by chondrocytes. Over time, the catabolic activities override anabolic activities and abnormal repair mechanisms lead to the formation of osteophytes, while cartilage continues to degrade.

The treatment for osteoarthritis is primarily symptomatic. Analgesics (pain relievers), non-steroidal-anti-inflammatory drugs (NSAIDS), weight loss, exercise, assistive devices such as wedge insoles, braces, canes, walkers, and such. Injection of glucocorticoids and viscosupplements (lubricants derived either from rooster combs or from bacteria) may also be helpful.

Nonetheless, eventually patients will require surgery in the form of joint replacement. Joint replacement surgery has come a long way, but there are still concerns about them. The first is the possibility of a surgical complication such as blood clot or infection. The second issue is the finite lifespan of the prosthesis. They usually last 10 to 15 years but this is a function of activity and joint replacement patients do have restrictions on their activity level. Persistent pain due to particle induced inflammation can also be a problem.

Finally, the chance of faulty prosthetic devices such as the recent Johnson & Johnson metal-on-metal hip debacle, makes the choice of total joint replacement less attractive. In future articles I will discuss an alternative, the use of autologous stem cells to help cartilage regeneration.

People who have problems with blood clots, fluid accumulation in the arms or legs, or who must remain immobile for long periods of type may need to use a type of medical pump called a sequential compression device, or lymphedema pump.

What is it?

A sequential compression device helps improve circulation in the feet, arms or legs. The device comes with a sleeve that is placed on the affected body part. The sleeve connects to an air pump. Once it's turned on, the lymphedema pump pushes air into the sleeve at varying intervals, which milks the arm or leg. It feels like a gentle squeeze. This opens up the veins and allows blood and fluid to flow more easily. Sometimes doctors refer to these pumps as intermittent pneumatic compression systems.

Who needs it?

Because being immobile for long periods of time increases the risk of blood clots, people who are having surgery (especially hip surgery or hip replacement surgery) may need these sequential compression devices. Also, people who are obese, have blood clotting problems, deep vein thrombosis, or arm or leg swelling may also find relief and better circulation if they use lymphedema pumps.

Research studies have also found these pumps to help people with a circulatory and sleep disorder called restless legs syndrome.

How much do they cost?

It depends on how many chambers they have. More chambers are more expensive, but also generally more effective. Health insurance may pay for a portion of a sequential compression device, which range from $600 to $3,000.

Osteoarthritis is the most common type of arthritis in older people. It is sometimes known as degenerative joint disease because in Osteoarthritis the cartilage of the joints continues to degenerated causing pain, stiffness and swelling as bone scrapes over bone.

People often have limited movement and pain but there is no redness, heat nor does it affect the internal organs like other arthritic diseases do. Osteoarthritis is the most frequent cause of disability in older adults. It affects more men before age 45 and more women after age 45. The disease causes not only changes in the person abilities but also their lifestyle and finances.

The joints commonly affected are the knees, hips, hands and spine. Patients start to notice a difference in their comfort level as they rise to standing from a sitting position, in the morning getting out of bed or after exercise.

Warning signs of Osteoarthritis include crackling joints, stiffness after getting up from a chair or from bed in the morning, pain, swelling, and tenderness. In Osteoarthritis there isn't redness or heat from the joint.

Doctors don't have a single test that will identify this disease. They rely on several methods to identify the changes and determine a course of treatment.

They will take an indepth clinical history to determine when the symptoms started, how they've been treated thus far and how they affect the patient's lifestyle.

Doctors will also include a physical exam, x-rays and other tests. X-rays aren't conclusive since most people over 65 have osteoarthritis in the joints but are not symptomatic. Blood tests can help to rule out other diseases that cause joint pain and swelling. Joint aspiration may also be performed to evaluate the fluid in the joint.

Osteoarthritis happens in the hands greater in women than men. There also appears to be a genetic factor as it seems to 'run' in families. Medication, splinting and moist heat give patients with arthritis in their hands the most relief.

Osteoarthritis in the knees is very common since the knees are the largest weight bearing joint and therefore commonly affected. The arthritis is not symmetrical and can occur in one knee or the other but not usually both at the same time. The knee becomes stiff, swollen and painful but isn't red or hot. The pain can lead to significant disability and a disruption in the patients lifestyle.

Therapy for Osteoarthritis in the knee often includes medications, necessary weight loss, walking aids and in extreme cases a joint replacement. Over weight and obese patient have an increased rate of Osteoarthritis. Decreasing the weight load that the knees and hips carry will treat the pain and disability of the disease. In fact, people who are over weight will decrease their chances of having painful Osteoarthritis just by maintaining a healthy body weight.

Osteoarthritis in the hip can be felt as pain in the hip, knees, groin, inner thigh or buttocks. When arthritis settles in the hip it can cause stiffness, pain and severe disability. The pain limits movement and bending which makes dressing and caring for the feet a real challenge.

Patients with Osteoarthritis in the hip often respond well to medications, exercise, walking aids and in severe cases a joint replacement. Again, patients with Osteoarthritis in the hip respond very well to weight loss.

Spinal Osteoarthritis may cause numbness or weakness in the arms or legs. Patients often report relief when sleeping on a firm mattress, using back support when sitting in a chair, and warm moist heat. Exercise can be incorporated to strengthen the back and abdominal muscles.

Osteoarthritis commonly affects four different joints in the body; knees, hips, hands and spine. With the proper identification and therapy people suffering from arthritis can delay the progression and pain of the disease.

Are you looking for the best treatment of knee joint pain? Most people suffer from minor or major knee problems particularly after a certain age. Sometimes, it can be a challenge to find out what the real cause of the problem is, whether it is due to sudden injury, an underlying condition like arthritis or an injury due to overuse of the knees.

How To Treat Knee Joint Pain

There are several treatments ranging from medication to natural remedies which can give relaxing and soothing effect to your soaring knee pain. Treatments for knee pain vary according to the cause of the knee pain, with some of the most effective treatments listed below:

1) Medication
This option involves getting some effective medicines prescribed by a doctor.

2) Therapy
- Orthotics and bracing: Braces, arch supports or wedges to shift the pressure from the knee joints are used.
- Physical therapy: Training and exercises to improve and strengthen the muscles around the knees, such as the quadriceps and hamstrings, are given to the patients.

3) Injections
Knee joints are treated with injections containing drugs like corticosteroids or hyaluronic acid which reduce the flaring pain of arthritis. These shots are very painful as they are injected in the knee joints.

Disadvantages Of Using Medication Or The Above Methods For Knee Pain
• May cause side effects
• Overdose of injections or medicines can trouble the person
• Slow healing process

4) Natural Remedies
Studies at a reputable Health Institute have discovered powerful herbal ingredients which include Lachesis Mutus, Naja, Belladonna, Rhus Tox and others. When these homeopathic ingredients are combined in one, it has the ability to stop pain and inflammation of joint pain quickly without any side effects. It has become one of the most popular options for many knee joint pain sufferers because of its effectiveness and speed in treating knee pain.

Advantages Of Using A Topical Cream As Treatment Of Knee Joint Pain
• Instant relief as soon as you apply it on the affected area.
• Carry it anywhere and use when needed.
• It does not irritate the skin or upset the stomach which some medications do.
• Zero side effects.

Going for natural treatments which contain homeopathic ingredients as mentioned is one of the most sought after remedy because of it zero side effects and ability to stop pain quickly. The breakthrough of discovering these homeopathic ingredients make such a natural remedy more favourable than medication or other therapies. It is definitely something worth looking at for those who are seriously looking for a safe and effective treatment of knee joint pain.

How are your knees doing lately?

Something tell us that you would not be here if everything was fine.

We are sorry that you are having knee issues, but while you are here lets discuss some important information.

The truth is, some knee pain is temporary and insignificant. - The problem is that you should not think like this when you have knee pain problems; we will tell you why.

1.) The pain might be a sign of something that is actually more serious.
2.) Instability issues should be examined before they worsen as well.

Braces can help in both of these instances.

When you have knee instability or knee pain problems one of the best things you can do is take your time. Surgery is not always the answer. At least not the first conclusion that a person should jump to. Upon speaking with your physician they will discuss the need for surgery, but often times they will look to more conservative measures of treatment for you.

When someone speaks of "conservative measures of treatment" for your knee, what do you think they mean? - Well we will tell you.

1.) Rest
2.) Improving your knee support with a brace

These are two helpful options for anyone to consider. - We actually like the idea of rest, but have problems with it alone. The reason why rest is helpful but not always a definitive treatment method is because people just don't have time anymore. Can you disagree? Do you have a ton of time to waste everyday? - Well ,if you do consider yourself lucky.

If you have time to rest your knee constantly then great, but even if you do you should seriously consider getting some knee support. We will tell you why.

Many people will look back at their choice to get a knee brace and feel good about the decision. People who get a well designed knee support will often say that their pain is reduced and that they have increased confidence as a result of wearing the brace. Not because the brace is magical or something, but it is because the brace will help to provide you with some extra support. This support will help maintain a proper knee alignment and also it will help to reduce your discomfort.

Some people also refer to their brace as a "pain pill". If this were the case then the extra benefit of a knee brace would be that you do not have to wait for the pain pill to kick in. Once you have the brace on, many of your pain symptoms can reduce due to the support it can provide. These braces can be obtained very quickly and you should consider getting one when your knee hurts.

There are a lot of different forms of tendonitis, all of which can cause quite a bit of pain in joints as well as other complications if the condition is ignored. Tendonitis can usually be diagnosed during a regular examination at a visit to the doctor's office.

X-ray machines and MRIs are not necessary, but an x-ray may be used to make sure that there are no other injuries to the area, such as broken bones, that could be the cause of the tenderness and swelling. MRIs may be used to identify where exactly the swelling is located in order to be treated more directly.

One of the many forms of tendonitis affects the wrist, which would cause a localized pain in the joints in that area. Wrist tendonitis can also be identified as tenosynovitis, a very common condition caused by the inflammation or irritation of the tenosynovium. These are a sort of tendon sheath that allows the wrist tendons to slide and allow the tendons to move smoothly with very low friction. If the condition is left unattended, it can lead to a far more serious condition from the thickening of the tenosynovium, which can keep the tendons from moving as smoothly as they should.

Symptoms of wrist tendonitis may vary, but the most common are swelling around the tender area. There are several forms of treatment, including the use of a wrist splint, which would immobilize the joint and allow it time to heal since the tendons are not being used. Applying ice to the tender area is also an option. This will stimulate blood flow to the area to assist in healing. You may also decide on an anti-inflammatory medicine which will help ease the pain, as well as control the inflammation and give the tendons the opportunity to heal.

Achilles tendonitis affects the large tendon that runs from the back of the ankle up the back of the leg. The condition seems to be more common in middle-aged recreational athletes. If the tendonitis goes untreated, it may lead to tears which could weaken then tendon even more, and make it more susceptible to rupturing.

The most common cause of Achilles tendonitis is a lack of flexibility. Other possible causes of joint pain caused by this form of tendonitis is a change in footwear or an exercise or training routine that the individual is not used to. As people get older, they begin to lose flexibility, which makes them more susceptible to injury-this is why middle-aged people are more likely to get suffer from this condition.

An important thing to remember is that the joint pain is caused by forms of tendonitis that won't go away on their own. Though it may stop hurting for an hour, or maybe even a couple of days, if the inflammation is not taken care of and the tendons healed, the pain in joints may cause other problems on top of the tendonitis.

A physical therapist working with a patient in hip replacement rehab will introduce the patient to a variety of exercises; exercises that may include both standing and lying flat.  Initially it may seem as if all the exercises introduced are only benefiting the successful movement and use of the hip. However, these exercises your physical therapists introduce are known to help a lot more areas of your body.

Gluteal sets is an exercise that requires an individual to lay flat on their back, preferably on the floor, while squeezing the buttocks for an interval of time before releasing.  The  move is to be performed several times in succession.  Whether starting out slow with just a few reps or digging in to do 10 reps in 4 sets, a person doing this move will appreciate the results. 

This exercise is designed to work 3 muscles at once: the gluteus maximus, medius muscle, and minimus muscle.  These muscles work together and help make everyday situations easier to handle, like climbing stairs and getting up from a seated position.  By mastering this routine, you're doing more than making sure life is easier, you're helping the look of a very prominent part of your body.

Arc quad sets is another exercise you may be introduced to.  You complete this exercise by lying flat on the floor while tightening your thigh muscles and straightening your knee.  This is a power move that strengthens all four muscles that run up the front of your thigh. 

If an individual is introduced to this exercise, they can rest assured that walking, running, or even jumping will be a lot easier to do.  When looking at someone standing sideways wearing a pair of shorts it's, easy to see if there's a defining line from working out; this is one of those moves that can help you achieve that look.

The standing knee raise exercise is as simple as lifting one knee at a time upward towards the chest.  This move can be done standing free or with the assistance of a chair.   The importance of this exercise during hip replacement recovery is that it works vulnerable skeletal muscles that surround the hip joint area.  These skeletal muscles are what keep your hip joints from feeling or remaining stiff. 

Everyday movement often taps into the flexibility of the hip joint and if the joint is in pain, the movement is painfully hard to achieve.  The great thing about working on this activity is that you actually begin to work stomach muscles.  While it may not be the move that can turn a stomach into an instant six-pack, it is one that well help you on your road to achieving it.

Facing your physical therapy appointment with the understanding that your whole body can benefit is one way to make sure that your hip replacement rehab visit is a productive one.

Running is the simplest form of whole body exercise, and it's becoming more and more popular nowadays as people are discovering that it easy to do. People take up running for various reasons. Some do it to keep fit, and some to lose weight while others find it rejuvenating.

However, it has been known that knee injury is the most common form of injury a runner can suffer. And at some point, many runners start experiencing some form of pain or injury in their knee after doing some running activity. It is common knowledge that while running the knee has to absorb a lot of impact, which can result in injury that might have long-term implications. If the knee injury gets serious, surgery is the only option for remedy, which again may not be effective in all cases.

The distressing fact about knee injury is that once you have it, there is no going back. Therefore, before you take up running, you need to adopt some kind of preventive measure in order to protect your knee from injury. The effective way to prevent knee injury is to use knee brace for running.

If you already have some kind of injury to your knee, it is important that you determine which brace will be the best for you based on the type of injury sustained. Here are some types of running braces that you can check.

1. Neoprene brace

Neoprene brace has the dual property of stretch ability and insulation. The brace tighten the knee movement and also insulate it from cold. It is mostly used when running in cold weather.

2. Hinged brace

These braces are more advanced than the neoprene brace. They are capable of providing more stability and less flexible. In fact, hinged braces can be adjusted in order to limit the range of movement of the knee at the required degrees of movement. These are available in standard form and also in adjustable form. Moreover, hinged knee brace for running can be customized according to the need of a runner.

3. Knee bands

Knee bands are generally straps. It wrapped around the knee in order to relieve stress on the tendon. These knee bands are generally used for treatment of runner's knee and tendonitis.

4. Arthritic knee brace

This brace are specially designed with hinges that reduce the friction between the bones, which in turn reduces the pain while running. This brace are perfect for person who suffers from arthritis.

5. Patellar stabilizing brace

Patella is the scientific name for kneecap. This brace helps in stabilizing the kneecap so that it properly tracks in the groove of the femur or thigh bone. Pain arises when the kneecap does not track properly. Patellar stabilizing brace has been designed to provide proper tracking of the patella. These braces are provided with block to hold the patella in position when the knee goes through motion.

When you are using knee brace for running, remember that it is not a solution for your injury. It is just a temporary appraise to helps your knees into proper shape and to relieve you from pain. You need to consult with qualified medical professional who will be able to provide you with the solution for your knee injury. Moreover, you also need to consult to the doctor who will be able to recommend you the appropriate brace depending on the type of injury you have sustain.

Getting a total knee replacement requires major surgery. In the operating room an eight inch incision will be made in your leg so the doctor has room to do his work. Whenever total knee replacement occurs, there is a small risk of infection. Even though the doctors and his assistants take every precaution to prevent infection, you are in a hospital. And hospitals are full of sick people.

It is a normal precaution for knee replacement surgery for the doctor to prescribe antibiotics to be included in your intravenous, both during and after the surgery for a few days. This helps protect you if you have been exposed. But there are things you can do to protect yourself. One of them is to ensure your own immune system is humming along at a high level.

There has been an explosion of books on boosting your immune system. Several that do a good job of explaining how you can ensure your immune system is operating at optimum levels are "The Immune System Cure", published by Kensington (2000), and "The Top 100 Immunity Boosters", published by Duncan Baird (2006). There are numerous others available, check your local book store.

In general terms, you should know that your immune system can be compromised if you are simply suffering from a deficiency in certain vitamins or nutrients. The famous Recommended Dietary Allowance (now called Reference Daily Intake) was developed in the United States during World War II to define the minimum allowance for "energy and eight nutrients" that would meet the requirements of 98% of the population. Note: these values were not the "optimum" levels, simply the amounts that would prevent deficiency diseases from occurring, with some additional safety margin. In most cases, optimum levels have not been determined for most vitamins and minerals.

The typical multi-vitamin has less than your required RDI of each item, frequently as little as 10% or less. It is expected that most of your vitamins and minerals will come form your diet, and this is the preferred source, because fresh foods typically include additional useful components such as flavinoids and other micronutrients. Nonetheless, depending on the freshness of your food, the amount of processing, and the variety of your diet, it is probably a good idea to take two of your usual one-a-day vitamin supplements each day, in the weeks leading up to your hospital stay.

In addition, there are two other products you may want to consider for their immune boosting effect. Echinacea is a well know, easily available, cold and flu relieving product that has proven immune system benefits. White blood cells are important components in your total immune system and Echinacea has been shown to both increase their number and their activity in study subjects. It also helps counteract an enzyme released by bacteria that allows them to penetrate human tissue.

Lomatium dissectum (fernleaf biscuitroot) is a plant with a long traditional of medicinal use by Native Americans. It first came to the attention of western medicine when Ernst Krebs, MD of Carson City noticed, during the great influenza epidemic of 1918 that killed over 20 million people world wide, that the local aboriginal peoples, the Washoe, were recovering more quickly than his other patients. Extracts of this plant are now being used in the treatment of numerous viral diseases, including Hepatitis-C, AIDS and Pneumonia. Since respiratory problems are of particular concern after surgery involving general anesthetic, you might want to consider a regimen of taking this product starting 3 or 4 days before your surgery.

You should always discuss supplementation with your doctor. Your case is different from everybody else's because you are an individual. However, there should be no problem with taking your multi-vitamin supplement. And there is no problem in making an effort to eat a varied diet, rich in fresh vegetables and fruits, with adequate sources of protein, all cooked as little as possible. Steaming, stir frying and roasting or grilling as opposed to deep frying or frying would be the preferred cooking methods.

Support your immune system, before you get into the hospital, so that it will support you while you are there, and after you get out.

If you suffer with joint pain, say in your knees for example, you are one of millions of others around the world who go through the same thing every single day. Arthritis affects more than seventy million people in the United States alone.

Contrary to popular belief arthritis is not just the bane of the elderly.

What causes this problem?

For many people a lack of exercise is one of the main reasons why their bones and joints are painful and stiff. Our skeletal system needs to be exercised. If exercise is neglected problems are going to arise, and not only with regards to our bones.

When the joints are sore and swollen immobility naturally occurs. We want to protect the affected area, afraid to do anything that might cause the pain and swelling to intensify. However, immobility is probably one of the reasons why the problem has occurred in the first place.

Another primary cause is a diet that is not nutritionally sound. When the diet is lacking the body will suffer in a multitude of ways. In order to function properly the human body has nutritional requirements that need to be met. When these are neglected issues arise. It really comes down to cause and effect.

What can be done?

First of all you need to know that you do not have to resign yourself to the idea of a life of joint pain. There are things you can do to alleviate the problem. For instance, if you suffer with knee pain you need to do knee exercises. Certain knee exercises will greatly help to reduce swelling and pain and increase mobility. And the good news is that it is never too late to start.

Nutritional Supplements

Nutritional supplements, such as those that contain New Zealand Green Lipped Mussel Powder are known to greatly benefit those suffering with joint pain. The green lipped mussel is a complete food that reduces inflammation in the joints. Coupled with vitamins, minerals, and other essential ingredients, these supplements can go a long way in helping you enjoy a more active and healthier life.

Why choose a natural supplement?

You might wonder why you should choose a natural supplement over a conventional medicinal one. While certain prescription drugs are very beneficial, natural remedies are safe and can be used in conjunction with other medications. They will not produce a range of unpleasant side effects. Also, unlike conventional medications, they will not cause complications in other areas of the body.

"Choose supplements and knee strengthening exercises to help you live a life free of joint pain and inflammation".

Knee joint pain can be caused by many things such as a knee injury from torn ligaments, worn out knee cartilage due to arthritis, or just a plain old knee joint infection. Even though there may be many reasons for knee pain, figuring out what is causing the affliction may require a trip to the doctor. For most people however, knee joint pain is cause by osteoarthritis.

Osteoarthritis is a disease that affects the joints by causing deterioration to the cartilage that supports it. When there is degeneration in these areas, it can cause arthritis pain and inflammation. These symptoms can be mild to severe depending on the stage of arthritis you are in.

The cartilage that protects the bones in the knee from rubbing against each other becomes worn out. When this happens, the bones begin to cause excruciating knee joint pain because bone is rubbing against bone. As time goes on, joint deformities, joint stiffness and limited range of motion can also occur.

Because arthritis affects over 40 million Americans, there has been extensive research on several natural supplements that help alleviate joint pain, rebuild cartilage and decrease inflammation. Three such supplements that is used to treat arthritis pain are glucosamine, MSM (Methylsulfonylmethane), and chondroitin.

Glucosamine is a natural substance that is found in the body. It is manufactured into a supplement from a natural compound called chitin found in shell fish like shrimp, lobsters, and crabs. Glucosamine is needed to produce glycosaminoglycan. Glycosaminoglycan is a molecule that helps repair and rebuild cartilage and other connective tissues.

MSM also known as Methylsulfonylmethane, is a natural source of sulfur which has been shown to reduce inflammation and strengthen collagen. Sulfur also helps get rid of excess mineral deposits found in joints and tissues. This supplement is often used in conjunction with glucosamine.

Chondroitin is also a substance that is found naturally in the body. It is manufactured by extracting beef cartilage into a supplement. It has found to be an essential building block for the body to produce new cartilage and it may also block enzymes that cause cartilages to breakdown.

There are other natural supplements like white willow bark that can alleviate knee joint pain. White willow bark was the inspiration behind the now famous aspirin but we all know that aspirin can cause side effects such as stomach irritation. If you decide that a natural supplement is right for you, make sure it has all the ingredients discussed here.

3 Things We Already Know About You...

A.) You do not want to get bored when reading this article.

B.) We know you do not want to mess around with your knee after an ACL reconstruction. - You will want the support it takes to make sure your knee does not continue to have problems!

C.) You do not want to spend way too much money on a brace.

We got you covered,... Let's get down to business.

After a surgical repair of your knee, you will want to support your knee in the correct way. - In order to do that, we need you to ask yourself 2 questions. You will understand why in a moment...

1.) What is your knee pain on a scale 1-10? On this subjective scale, 10 is the highest your pain could be... Please record the answer you get.

2.) What is your knee instability on a subjective scale 1-10? 10 is again, the worst. Again, please record the answer you get.

(If after reviewing your numbers and you find that you have moderate to severe knee pain or instability, then this article was written for you. If you have mild knee pain or instability this article can still help you, and you will see how at the end of this article... )

Taking Your ACL Reconstruction Seriously

Let's face it. Sometimes you have no choice but to have surgery. Other times it is more of an elective procedure for an ACL reconstruction, but either way, you will need to protect your knee after surgery.

There are:

(A) "Post-operative" knee braces for the moment you get out of surgery,

and there are

(B.) knee braces you can use for the rest of your activities, once your physician has cleared you to get active again.

When it is time to get your functional knee brace (one that was not used directly after surgery) you will need to get the best one possible (at an affordable price) and here we will talk about a few things to remember. This part can save you some serious time and money!

Lightweight Design

Many supportive knee braces avoid being bulky and heavy by using a quality material called, 6061-T6 aircraft aluminum. This material is both lightweight and strong. If you want to get a bulky brace or make your leg feel heavy you might want to think about other materials...

Non-custom vs Custom Knee Braces

Money Saving Time! - Some people are tricked into thinking that any knee brace has to be custom made in order for it to be effective. This is not the case! In fact, many times you might pay up to $1500.oo for a custom knee brace, when you could have paid less than 1/3 of that for an equivalent non-custom support. - Trust us, we are licensed brace specialists. We are honestly trying to save you some cash here...

Prophylactic Use: Whether you are an active adolescent or adult, and you like to play contact, extreme, and/or water sports a well designed knee brace can help support and protect your knee from further or future injury. If you are concerned that you might hurt yourself, or hurt yourself even more than you currently are now, then a knee brace can help you maintain proper alignment and help promote healing!

Knee replacement surgery is an invasive procedure that involves removing the damaged joint and inserting an artificial knee joint in its place. Afterwards, most patients undergoing total knee replacement surgery are told by their doctors to wear compression stockings. Compression garments are meant to improve blood flow in the part of the body where they're worn. When it comes to knee replacement surgery, thigh-high support stockings are worn daily during recovery to assist in improved circulation.

Purpose
After knee replacement surgery, patients must stay off their feet for a few days, although foot, ankle and leg motion exercises are recommended to assist in stimulating blood flow. The compression stockings are used to improve blood circulation and minimize the risks of blood clots. They also help to keep swelling down. The patient's orthopedist or surgeon can recommend the proper size and type of support socks, including how long and how often they should be worn. Incisions may run about six inches to a foot long and will be sutured or stapled shut. The patient wears a dressing over the wound until it heals. The compression stockings can be worn over the wound dressing.

Duration
Recovery from knee replacement surgery lasts several weeks to several months. Within a few days of surgery, patients will learn from a physical therapist how to move their new joint and begin a program for standing and walking. Most patients are released from the hospital once they are able to get in and out of bed and walk with the assistance of crutches. The stockings should be worn for longer periods of time in the beginning, with the patient following the doctor's recommendations on how long to take them off and when to keep them on. After a time, they will only be worn during the daytime, and eventually may not be needed, depending on the individual.

Style
Support Stockings after knee replacement surgery typically pull up to the thigh. There are support knee-highs and waist-high styles also available, but due to the location of the surgical site, the blood flow is not normal at the knee and must be stimulated.

Changes in Time
The early days of compression hosiery began with thick white stockings with bold seams running down the back of the legs. They were often toeless, made of a rubber blend and smelled funny. Today's compression stockings come in white, beige and black. The seams and toes are optional and the material is more likely made of a nylon blend. While some brands still use rubber components, it is more likely a small percentage of silicone rubber in a weave with nylon and other stretchy fabrics. While some patients find their feet smell funny, it is often when they are cooped up in shoes or slippers that don't breathe. Lotion on the feet or powder in the shoes will help to alleviate foot odor.

It is not unusual for a person who finds out that he or she (or a loved one) needs a pacemaker to feel suddenly isolated and alone. There is not a great deal of information online, either. But here's a surprise. Pacemakers have helped literally millions of people all over the world for the past five decades.

But you probably do not know a lot about pacemakers. There isn't a lot of information about them, even online.

First of all, pacemakers may seem like some futuristic, bionic device, but they've actually been around for over 50 years. That's right, I Love Lucy was not yet in re-runs when the first pacemakers were implanted.

Second, pacemakers have proven themselves to be a safe, effective technology. The pacemaker is implanted in your upper chest; an insulated wire is passed through a vein into your heart. The wire is plugged into the pacemaker, which then delivers electricity (not drugs or artificial ingredients) to your heart. They send the heart tiny amounts of electricity.

A healthy heart produces electrical impulses on its own. If you need a pacemaker, it is likely because your heart does not produce these electrical impulses fast enough or conduct the electricity through the heart muscle quickly enough to keep your heart going at the right rate. The pacemaker just "fills in the missing beats" by sending electricity to the heart. Electricity is electricity, after all.

Pacemakers are tiny devices about the size of a pocket watch. They are made of titanium, a lightweight metal that doctors call "biocompatible." This means it is compatible with the human body; the body does not react to it or reject it.

It is hermetically sealed and runs on a battery. In fact, most of the interior real estate of a pacemaker is taken up by a lithium-iodide battery.

Your pacemaker is designed to run for years on that battery! How long the device actually lasts depends on many factors but the doctor can help you predict it. Pacemaker patients go for checkups at least twice a year, and part of the checkup will tell you how the battery is doing.

The miracle of the pacemaker battery is that it does not just suddenly conk out like a flashlight battery. Instead, it operates at full capacity and can signal the device (and the doctor will know how to get this information) when it is starting to wear out. You will have some "grace" time to schedule your replacement.

When a pacemaker wears out, you don't replace the battery. First of all, most of the device is the battery and it's hermetically sealed. Instead, doctors go back and remove the old pacemaker and replace the new one. The leads or wires are unplugged but left in place. When the new pacemaker is implanted, the old leads are plugged into the new device.

Replacement surgery or "pacemaker revision" as it sometimes called is a much faster procedure than the first implant. In fact, it is often done on an outpatient basis.

Surgery to implant a pacemaker may seem scary, but for your hospital team it is a fairly simple procedure. In medical terms, it's called "minimally invasive" because the incision needed is quite small. It is typical for a pacemaker to be implanted in a cardiac catheterization or electrophysiology lab rather than a full-blown operating room.

As the patient, you may be surprised to find out that the doctors prefer you to be awake. You will be draped (that is, you won't be able to see where they make the incision) and given some sedatives to relax you, but most pacemaker recipients do not require full anesthesia.

You will get some numbing medicine for your chest. A small incision is made and a spot is created just under the skin and tissue for the pacemaker. A tiny incision is made in a vein and the insulated wire is passed through the vein and into your heart.

This wire is called a "lead" and you may get one, two or even three of them, depending on the type of pacemaker you get.

Interestingly, it is the lead that takes most of the time during your implant procedure. The doctor gently advances the lead through the vein. He and the rest of the implant team (you'll have several people in the room with you besides the doctor) will observe what's happening on monitors. They use a large device called a fluoroscope to get video X-rays which show how the lead is navigating its way into your heart.

Once in the heart, the doctor needs to get it to attach or "fixate." It is not very hard to fixate the lead, but some parts of the heart conduct electricity better than others. This is highly individual, so the doctor is going to want to test the first landing site to see how good it is. This is done using a small hand-held device that sends a small amount of electricity through the heart to force it to beat.

You will not feel this at all. However, you may notice when this is going on, because it can be quite loud. The doctor is busy looking at where the lead is fixated while some member of his team is busy testing the lead. People are going to be calling out numbers, even shouting across the room. Somebody else is probably watching the EKG (that's another monitor) and may shout out more numbers. If you don't know what's going on, it can be confusing or even disconcerting.

Once the doctor fixates the lead(s), the other end of the wire is plugged into the pacemaker, the pacemaker is placed in the little space in your chest, and the incision is sewn up. The whole procedure can take up to two or three hours (depending on how many leads are used and your individual case) but it may be less.

Most pacemaker patients need a few days to recover and then a few weeks before they can resume their old activities. While there may be a few restrictions on pacemaker patients, most people feel better than they did before and report that they can actually do more even with a few restrictions.

Right after your implant, you will likely be asked to see your doctor a few times. This is to check on the surgical incision and run some preliminary tests and make adjustments to your pacemaker.

Once the initial phase is completed and your system is stable, the doctor will give you a plan for regular checkups, typically once a quarter or every six months. Please make every effort to keep these appointments, even if all the doctors end up telling you is that you're doing just fine.

That's because your pacemaker can report or communicate to the doctor about how it is doing, suggest adjustments that may help it to work better, and will tell you how much service life is in the battery.

Millions of people have pacemakers. You may even know some people who have them that just never mentioned them. That's because many pacemaker patients report that after a while, they "forget" about the device. With no pills to remember and only occasional doctors' appointments, it's pretty easy to forget about this silent servant.

Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative, or wear and tear, arthritis. OA commonly affects the knee joint. Osteoarthritis (OA) is the most common joint disorder.

As part of the aging process, joint fluid decreases. With wear and tear, the cartilage becomes thinner. If the muscles and tendon protecting the joint become weakened, if there is overweight, or if there is persistent abnormal posture or activities such as squatting or sitting on low stools, the condition would become worse.

Most of the time, the cause of OA is unknown. It is mainly related to aging, but metabolic, genetic, chemical, and mechanical factors can also lead to OA.

Symptoms Osteoarthritis include:

o The most common symptom of osteoarthritis in any joint is pain that worsens during activity and gets better during rest. As the disease advances, the pain may occur even when the joint is at rest.
o Grating of the joint with motion
o Pain seems to increase in humid weather
o Joint swelling
o Limited movement
o Morning stiffness

A physical exam can show limited range of motion, grating of a joint with motion, joint swelling, and tenderness. An x-ray of affected joints will show loss of the joint space, and in advanced cases, wearing down of the ends of the bone and bone spurs.

The most common medications used to treat osteoarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs). Injections of steroids into the joint can relieve pain but it would aggravate the arthritis. It should not be used unless absolutely necessary.

Surgery may be required for certain severe cases of deformity. These include arthroplasty and knee replacement therapy.

India healthcare are globally developed with best medical facilities & world class treatment by internationally certified Surgeons.

There are dedicated specialized hospitals in India achieved accreditation from Joint Commission International ( JCI ) standard. JCI is gold standard in global healthcare standard like Indraprastha Apollo Hospital (New Delhi - located in North India), JCI Accredited Apollo Hospitals (Chennai - located in coastal South India), Wockhardt Hospital, Mumbai. They availed high quality and cost effective advanced surgery in India.

The Hopsitals is best in the world in terms of

o State of the art diagnostics.
o World class operating theaters & Intensive care unit.
o Highly Qualified & experience doctors & surgeons may be trained abroad.
o English speaking highly trained paramedical staff.

A price range of 5000- 7000 US dollars is quoted for a Knee replacement depending upon the type of implant chosen and the class of accommodation.

The benefits of low-impact aerobic exercises in helping knee problems are huge. There are multiple benefits in using aerobics for knee strengthening exercises including building up the muscles round the knee, weight loss and stimulating the body to release its natural painkillers, endorphins. Here is some brief information on each of these benefits.

MUSCLE STRENGTHENING

There are muscle groups around the knee that help to support the knee joint by absorbing a lot of the shock that would otherwise be transferred to the knee joint. Toning and strengthening these muscles using low-impact aerobics helps these muscles take a lot of stress away from the knee.

WEIGHT LOSS

Another benefit of an aerobic exercise routine in your knee exercise program is weight loss. Being overweight is one of the biggest causes of knee pain and knee problems. It has been shown that when walking, the knee is subjected to impact equivalent to three times your body weight. Just imagine what this would be if you were running. Keeping your weight down therefore reduces this shock on the knee joint.

ENDORPHINS

When we exercise using aerobics, the body releases its own natural painkillers called endorphins. These help to reduce pain in the knee joint.

WHAT TO DO BEFORE AND AFTER EXERCISING

To ensure proper function of our bodies, including the heart and lungs, we all should do some sort of aerobic exercise. What we need to avoid when exercising is putting the weight bearing joints. knees, ankles and hips, under a lot of stress. Avoiding high impact exercises and using low impact exercises, like low impact aerobic exercises, will assist in preventing knee and other joint problems and in ensuring knee and joint pain is minimised.

Before starting an aerobic exercise session, it is important warm up properly. A few minutes of walking and some stretching exercises will allow a gradual warm up. Important muscles to stretch are the hamstrings and quadriceps, the knee supporting muscles.

Don't "over-exercise". When muscles get tired, their shock absorbing capabilities are dramatically reduced. This means that the joints, ligaments and tendons take the extra stress thus making them more susceptible to injury.

Allow your body to repair itself by exercising only every other day. "Over use" injuries are common and so easily avoided.

If you are pregnant it is important to check with your medical practitioner or physiotherapist on the safety of your exercise routine. When pregnant, the body releases hormones that causes tendons and ligaments to become looser and increases the flexibility of the pelvic bones. This can increase the risk of exercise related injuries to joints, especially if doing high impact exercises.

THE BEST LOW-IMPACT AEROBIC EXERCISES

If you have any knee problems or knee pain, check with your medical professional or physiotherapist before commencing aerobics to ensure the exercises are safe.

WALKING - Walking is a great low-impact exercise but there are some guidelines you must follow.

Walk at a slower pace for a few minutes when you first start, to warm up.
Only walk on even and level surfaces.
Wear proper shoes that provide cushioning in the soles and support.
Slowly increase the intensity of the walking and gradually build up to around 45 - 60 minutes.
Be careful to not over exert yourself.

SWIMMING - Swimming is a great aerobic exercise because it puts no impact stresses on the joints and gives the muscles an excellent workout. Highly recommended.

OTHER WATER BASED EXERCISES - Water based exercises are recommended as the water's natural buoyancy properties supports most of your body's weight, taking load off the knee joints. Exercising in water is excellent for strengthening muscles as they must work harder to overcome the resistance of the water.

CROSS TRAINERS OR ELLIPTICAL TRAINERS - These provide intense cardio exercise with low impact on the knees. They also exercise most of the body's main muscle groups, including those that support the knee joint, and can be an excellent method to lose weight.

EXERCISE BIKES (Stationery) - These provide excellent low-impact cardio workouts like the cross trainers but there are a few important points to know about.

Set the seat height so your knees do not bend more than 90 degrees.

When the pedal is at its furthest point from you, your knee should be slightly bent.

If you suffer from lower back problems, a recumbent bike may be the answer. These usually offer cushioned support for the back and better seating. However, a recumbent bike will give a lower intensity workout than a conventional exercise bike.

Low-impact aerobic exercises can provide huge benefit in preventing knee injuries and knee problems and also in providing knee rehabilitation exercises following knee surgery or knee pain treatment.

Always consult with your medical professional before commencing any exercise routine.

The most common form of arthritis is osteoarthritis (OA). It affects almost 30 million Americans and the incidence is expected to rise with the graying of the Baby Boomers.

OA is a disease that affects the hyaline articular cartilage of joints. The exact mechanism of disease development is still being researched but there appears to be a trigger that causes a metabolic abnormality to occur. Cells, called chondrocytes, inside the cartilage begin to elaborate destructive enzymes which cause the surrounding matrix to degrade. In addition, inflammatory changes involving the synovium- the lining of the joint- contribute to further cartilage damage.

OA affects primarily weight-bearing joints such as the neck, low back, hips, and knees. I will focus on the knee.

Treatment for OA of the knee is primarily symptomatic. This involves the use of exercise, weight loss if indicated, patient education, analgesic medications, non-steroidal-anti-inflammatory drugs (NSAIDS) - either oral as well as topical, and injections.

The most common type of injection given for OA of the knee is a corticosteroid ("cortisone") injection. These are effective for reducing pain short-term and also helping to improve quadriceps muscle strength by reducing the inhibition of quadriceps reflex due to the presence of inflammation and swelling. Usually fluid is withdrawn from a swollen joint at the time of corticosteroid injection.

Corticosteroid injections are usually given to patients who are already taking oral medications such as NSAIDS. These injections may be given as often as three times a year. More often and they can actually cause more cartilage damage.

The second type of injection is hyaluronic acid. These types of injections are often referred to as viscosupplements since they are used to reduce pain but also provide a lubricating quality as well. Some preparations are derived from rooster combs and others are synthetically manufactured. There are many different formulations available. Despite claims that one product is superior to others, there is no concrete data that one preparation is superior to others.

These injections are often used as a last-ditch effort to help patients avoid having to undergo knee replacement surgery. As with corticosteroid injection, withdrawal of joint fluid always precedes injection of the viscosupplement.

Whether the injection is corticosteroid or hyaluronic acid, each needs to be administered using ultrasound needle guidance in order to ensure proper delivery of the medication to the joint space. Reports of inadequate response to these preparations probably are more related to poor injection technique rather than to the shortcoming of the medication.