Name of the Procedure:

Hyaluronan or Derivative, Hymovis, for Intra-articular Injection, 1 mg (HCPCS Code J7322)

Summary

This procedure involves injecting Hymovis, a hyaluronan derivative, directly into the joint space (intra-articular) to relieve pain and improve joint function.

Purpose

This injection is used primarily to relieve pain and improve mobility in patients suffering from osteoarthritis of the knee. The goal is to restore the lubricating and shock-absorbing properties of the natural synovial fluid in the joint.

Indications

• Moderate to severe osteoarthritis of the knee.
• Persistent joint pain not adequately managed by conservative treatments such as physical therapy, pain relievers, or non-steroidal anti-inflammatory drugs (NSAIDs).
• Decreased joint function and mobility impacting daily activities.

Preparation

• No specific fasting is required.
• Patients should inform their healthcare provider about any medications they are taking, especially blood thinners.
• Diagnostic imaging such as X-rays or MRI might be conducted to assess the condition of the joint.

Procedure Description

1. The patient is positioned comfortably, typically lying down or seated with the affected knee exposed.
2. The area around the knee is cleaned and sterilized.
3. Local anesthesia may be administered to numb the area.
4. Using ultrasound guidance, a fine needle is inserted into the joint space.
5. Hymovis is injected into the joint.
6. The needle is removed, and a bandage is applied.

Duration

The actual injection process takes about 10 to 20 minutes. With preparation and post-procedure observation, the entire visit may last around 30 to 45 minutes.

Setting

Typically performed in an outpatient setting, such as a hospital clinic or a physician’s office.

Personnel

• Orthopedic surgeon or rheumatologist.
• Nurse or medical assistant.
• Radiologist or technician for ultrasound guidance, if used.
• Anesthesiologist or nurse for administering local anesthesia.

Risks and Complications

• Common risks: Temporary pain or swelling at the injection site, mild redness.
• Rare risks: Infection, allergic reaction to the injection material, bleeding, or damage to the joint structures.

Benefits

• Pain relief typically begins within a few days to weeks.
• Improved joint function and mobility.
• Reduced need for oral pain medications.
• Possible delay in the need for knee replacement surgery.

Recovery

• Patients are usually advised to rest for a few hours after the procedure.
• Light activities can generally be resumed within 24-48 hours.
• Avoid strenuous activities for a few days post-injection.
• Follow-up appointment may be scheduled to assess the response to treatment.

Alternatives

• Physical therapy
• Oral medications (NSAIDs, acetaminophen)
• Corticosteroid injections
• Platelet-rich plasma (PRP) injections
• Knee replacement surgery
• Each alternative comes with its own set of benefits and drawbacks, discussing with a healthcare provider is essential for choosing the appropriate treatment.

Patient Experience

• Mild discomfort may be felt during the injection.
• After the procedure, some patients experience temporary pain relief in the injected joint.
• Pain management may include over-the-counter pain relievers.
• Most patients return to normal activities within a day or two, with significant improvements typically noted within a few weeks.