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Synovial Replacement Therpay : A boon to Osteoarthritis Knee Pain

A young lady around the age of 45 came to me narrating the discomforting pain she experienced while climbing the stairs of a three storied building which did not have any lift. She expressed her feelings of frustration and helplessness and asked “What can I do to relieve the pain in my knee.” The lady patient said she had tried all sorts of things to deal with the pain. Numerous gels and ointments, anti-inflammatory tablets and even exercise but nothing seemed to ease the crippling that had come to be part of her daily experience while walking or climbing stairs. She wondered if this was something that she would have to learn to live with. She was actually a patient of early knee osteoarthritis (OA). Knee and other joints start to deteriorate for several reasons. Constant stress on the knees because of day to day activities causes havoc with many joints particularly knees. Aging, heredity and diet also play a role. Like a car on a bumpy road, joints are jolted every time you move. Even the simple act of walking produces pressure on knees. Only if you have experienced osteoarthritic pain you will be aware of the impact it can have on the mobility, quality of life and confidence. One of the most common misconceptions about knee osteoarthritis is that it only affects older people. While the risk of osteoarthritis increases with age, it can affect individuals of all ages. In India, osteoarthritis is the second most prevalent disease in the younger generation belonging to the age group of 25-35 years and affects more than 12 per cent of the population. Arthritis is a major cause of concern, especially when it affects young earning members whose lifestyle requires them to remain active and independent. Pain and stiffness are early signs and symptoms. It is very common for young knee osteoarthritis patients to ignore the early symptoms and seek expert opinion only when the disease reaches an advanced stage. Cars have shock absorbers to smooth the ride; our bodies have synovial fluid to cushion the impact between bones and joints. For this function the elasticity and viscosity of Synovial fluid are critical for smooth mobility. The synovial fluid also provides nutrition to cartilage which is like a protective covering on the ends of the bones and plays an important role in three functions: provides almost frictionless movements at the joint, distributes load evenly and promotes joint stability by acting as a cushion. In OA the cartilage starts to wear away exposing the bones leading to friction amongst them and causing pain. Studies show that in OA synovial fluid starts depleting and the elasticity & viscosity is affected. It is important to understand that unless one directly deals with the issue of wear and tear of knees, osteoarthritis knee will not be treated properly. Traditionally, Knee OA is largely dealt in two stages viz. pain killers in early stage and Knee Replacement surgery in late stages as the last option. For some people losing weight and increasing exercise levels may be all that is needed to relieve their pain. However for some people, like this lady patient they are not always successful. If the simple lifestyle changes do not help, doctors have number of other treatment options available. One needs to understand the fact that pain killers actually lead to damage of knees at a faster rate with associated effects of pain killer’s viz. gastric irritation. AIN It is appropriate to consult your Pain specialist as soon as your knee starts complaining of pain and hinders your routine activities rather than waiting for it to progress to advanced stages. You don’t have to settle for knee OA pain. There are several treatment options available for OA knee pain depending on the stage and severity of the disease. It always helps to know your OA treatment options. Talking to your doctor is the best way to start exploring your treatment options. And when you do, keep in mind: Pain affects everyone differently: The severity of your OA as it appears on an X-ray may not reflect the amount of pain you feel. Some people with OA that appears mild on an X-ray may feel a great deal of pain. Others, whose X-rays show severe OA, may feel less pain. Your doctor is relying on you to give a clear description of how your knee feels. OA is caused by more than just cartilage loss In knees with OA, the cartilage protecting the ends of the bones gradually deteriorates, joint fluid loses its shock-absorbing qualities, and bones may begin to rub against each other—all of which may cause the knee pain you’re feeling. OA can be very mild or so severe that it limits your everyday activities. With scientific developments in the last decade there are suitable options available which offer an effective and safe treatment to the ever increasing problem of knee osteoarthritis. One such option is Synovial Fluid Replacement therapy. Synovial Fluid Replacement Therapy is an innovative treatment for patients who are still in the early stages of knee osteoarthritis and want to maintain their mobility. It provides long term pain relief with no side effects. It is the best suitable option at stages where your cartilage surface has not completely eroded. It is in in fact the way forward for osteoarthritis Knee pain management. Synovial Fluid Replacement Therapy could be the best choice for you as it helps address the problem at the source and you avoid taking medications for long periods of time, and helps you keep the nasty side effects at bay. It is also a quick procedure that in most cases, can be repeated. You could also try the treatment on both your knees. So if you don’t want your life crippled by bad knees, it could be your best option. Its benefits include • Local solution to a local problem i.e. it targets the disease where it occurs • Replaces diseased osteoarthritic synovial fluid in the knee • Provides Pain relief and reduces stiffness • Improves mobility and ability to perform daily activities without hindrance • Provides long-term, non-systemic pain relief for knee OA • Reduces the use of chronic, systemic pain medications like NSAIDs and COX-2 inhibitors • Low rate of complications There is robust scientific evidence for this therapy and Millions of knees across the globe have benefitted with this treatment. Targeting pain at the source with Synovial Fluid Replacement therapy may help. Talk to your doctor about treatment options, including Synovial Fluid Replacement Therapy and Establish a plan to manage your pain over the long term.

Dr (Maj) Pankaj N Surange

MBBS, MD, FIPP (Hungary)

Director, Interventional Pain and Spine Centre Vice- chairman,

World Institute of Pain-India section International member,

Spine Intervention Society


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