Name of the Procedure:

Hyaluronan or Derivative, Orthovisc, for Intra-Articular Injection, Per Dose (HCPCS Code: J7324) Common names: Orthovisc Injection, Hyaluronic Acid Injection, Viscosupplementation

Summary

Orthovisc injection is a medical procedure that involves the administration of hyaluronic acid into a joint, typically the knee. This is done to relieve pain associated with osteoarthritis by lubricating the joint and improving its function.

Purpose

Orthovisc injections are primarily used to treat osteoarthritis in knees, providing pain relief and improving joint mobility. The goal is to reduce joint pain and increase functionality, allowing patients to perform daily activities with greater ease.

Indications

• Moderate to severe osteoarthritis of the knee.
• Patients who have not responded adequately to conservative treatments like physical therapy, pain relievers, or steroid injections.
• Candidates who are looking to delay joint replacement surgery.

Preparation

• No specific fasting required.
• Patients may need to stop taking blood-thinning medications a few days before the procedure, as directed by their healthcare provider.
• Pre-procedure assessment may include medical history review and imaging tests like X-rays or MRIs.

Procedure Description

1. The patient sits or lies down with the affected knee exposed.
2. The healthcare provider cleans the injection site using antiseptic solution.
3. A local anesthesia may be applied to numb the area.
4. Using a sterile needle, the Orthovisc is injected directly into the knee joint.
5. The procedure typically includes a series of three to four injections, scheduled one week apart.

Duration

The injection process itself takes about 15-20 minutes, though the entire appointment may last about 30 minutes including preparation time.

Setting

Typically performed in an outpatient clinic setting or physician's office.

Personnel

• Licensed healthcare provider (e.g., orthopedic surgeon, rheumatologist, or trained GP).
• Medical assistant or nurse.

Risks and Complications

• Common: Pain at the injection site, swelling, mild bruising, local stiffness.
• Rare: Infection, allergic reaction, bleeding within the joint, increased pain.

Benefits

• Pain relief in the joint.
• Improved joint function and mobility.
• Results can be noticed within days to weeks after the injections and may last for several months.

Recovery

• Patients can usually resume normal activities immediately but are advised to avoid strenuous activities for the first 48 hours.
• Follow-up appointments may be necessary to assess the effectiveness and schedule subsequent injections if needed.

Alternatives

• Physical therapy and exercise regimens.
• Oral pain medications (NSAIDs, acetaminophen).
• Corticosteroid injections.
• Surgical options like arthroscopy or joint replacement.
• Alternative treatments have their own pros and cons, such as varying durations of relief and different risk profiles.

Patient Experience

• Patients may feel slight discomfort during the injection, similar to a typical needle prick.
• Mild soreness or swelling can occur post-injection but can be managed with ice packs and pain relievers if necessary.
• Most patients report an improvement in symptoms within a few weeks of the final injection.