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Hyaluronan or derivative, monovisc, for intra-articular injection, per dose

HCPCS code

Name of the Procedure:

Hyaluronan or Derivative, Monovisc for Intra-Articular Injection (HCPCS J7327) Common name(s): Monovisc injection Medical term: Hyaluronic acid intra-articular injection

Summary

Monovisc is a single-dose injection of hyaluronic acid administered directly into a joint, commonly the knee, to provide temporary relief from pain and improve joint function. It acts as a lubricant and shock absorber in the joint space, helping to alleviate symptoms associated with osteoarthritis.

Purpose

Medical Conditions: Primarily used to treat osteoarthritis of the knee. Goals/Outcomes: To reduce joint pain and improve joint mobility and function, enabling better quality of life for individuals with joint disorders.

Indications

Symptoms/Conditions:

  • Persistent knee pain due to osteoarthritis not adequately relieved by conservative treatments like physical therapy or oral medications.

Patient Criteria:

  • Patients with moderate to severe knee osteoarthritis.
  • Patients who have not responded well to other treatments.

Preparation

Pre-procedure Instructions:

  • No specific fasting required.
  • Continue with regular medications unless otherwise instructed by a healthcare provider.

    Diagnostic Tests/Assessments:

  • X-rays or MRI of the knee to confirm osteoarthritis.
  • Physical examination of the joint.

Procedure Description

  1. Joint Preparation: The knee area is cleaned and sterilized to prevent infection.
  2. Anesthesia: Local anesthetic may be applied to numb the area.
  3. Injection: Using a fine needle, Monovisc is injected directly into the joint space.
  4. Post-Injection Care: The patient may be asked to move the knee gently to distribute the medication evenly.

Tools/Equipment: Syringe, fine needle, antiseptics.

Duration

The procedure typically takes about 30 minutes, including preparation and post-injection observation.

Setting

Performed in a medical office, outpatient clinic, or hospital outpatient department.

Personnel

  • Orthopedic surgeon or Rheumatologist
  • Nurse or Medical Assistant

Risks and Complications

Common Risks: Mild pain or swelling at the injection site. Rare Risks: Infection, allergic reaction, bleeding, joint stiffness. Management: Most side effects are mild and temporary. Severe complications might need further medical intervention.

Benefits

  • Relief from knee pain within a few days.
  • Improved joint mobility.
  • Reduced need for pain medications.
  • Possible delay in more invasive treatments, like surgery.

Recovery

Post-Procedure Care:

  • Rest the knee for 24 hours post-injection.
  • Avoid strenuous activities for a few days.
  • Ice application to reduce swelling.

    Recovery Time: Most patients resume normal activities within a few days. Follow-up: Scheduled check-ups with your healthcare provider to monitor progress.

Alternatives

Other Treatment Options:

  • Physical therapy
  • Oral pain medications (NSAIDs, acetaminophen)
  • Knee braces or supports
  • Corticosteroid injections
  • Surgical options (e.g., arthroscopy, knee replacement)

Pros and Cons:

  • Non-invasive alternatives may be less effective for severe cases.
  • Surgery may provide a more permanent solution but comes with higher risks and longer recovery.

Patient Experience

During Procedure: Minimal pain due to local anesthesia; the patient may feel pressure during the injection. After Procedure: Mild soreness or swelling which can be managed with ice and over-the-counter pain relievers. Pain Management: Local anesthetic used during the procedure, additional pain relief if necessary post-procedure.

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