Canada Viscosupplementation : Viscosupplementation For Osteoarthritis In Canada

Osteoarthritis, also known as degenerative arthritis, is the most common form of arthritis affecting millions of Canadians. It occurs when the protective cartilage that cushions the ends of bones wears down over time. This causes friction and damage to the bone beneath leading to pain, swelling and reduced mobility in the joints. The knee, hip, lower back, neck, small joints in the fingers are commonly affected areas. Obesity, joint injuries, age and genetics are some of the key risk factors for developing osteoarthritis.

How Does Canada Viscosupplementation  Work?

Viscosupplementation involves injecting a gel-like substance called hyaluronic acid or HA into the knee joints. Hyaluronic acid is a natural substance already present in the joints that acts as a lubricant and shock absorber. In osteoarthritis, the levels of HA in the joint decrease which results in loss of cushioning. The injected HA supplements this loss and restores the natural viscoelastic properties of the synovial fluid. This helps reduce pain and improves mobility by decreasing inflammation, stimulating the production of HA by the synovial cells and protecting cartilage surface from breakdown.

Common Products Used

Some of the commonly used viscosupplementation products approved for use in Canada include:

- Synvisc-One: A single dose injection containing high molecular weight HA approved for treating pain in knees caused by OA.

- Hyalgan/Supartz/Orthovisc: These contain lower molecular weight HA and require weekly injections over 5 weeks. They are indicated for reducing pain and improving joint function.

- Euflexxa: This HA product is administered as 3 weekly injections for knee OA pain relief.

- MonoVisc: Approved for a single injection, it replenishes HA levels in the knee for 6 months.

- Gel-One/Gelsyn-3: Both contain cross-linked HA requiring 3 weekly injections. They have demonstrated long-term pain relief for knee OA.

Patient Selection And Treatment Regimen

Viscosupplementation is generally recommended for patients who have not found adequate pain relief from medications like NSAIDs or those not willing to consider surgical options like knee replacement. The doctor will first conduct a physical exam and confirm the diagnosis is knee OA through X-rays before approving treatment.

The injections are administered in an outpatient setting under sterile conditions. A local anesthetic is used to numb the area before injecting the gel directly into the knee joint using an ultrasound or fluoroscopy guidance. Depending on the product, a single dose or multiple weekly injections may be required for maximizing benefits. Patients are advised rest post the procedure and can resume normal activities once any pain or swelling subsides.

Effectiveness And Safety

Multiple clinical trials and meta-analyses have proven viscosupplementation to be an effective treatment for alleviating knee OA pain. Research shows HA injections provide significant improvement in pain levels, physical function and reduced stiffness over placebo for 6 months on average. They have also shown to delay the need for knee replacement surgery in certain patients.

The treatment is generally very safe with minimal side effects like temporary pain, swelling or tenderness at the injection site after the procedure. Serious adverse reactions are extremely rare. As it only contains natural HA compound, viscosupplementation does not possess the gastrointestinal or liver toxicity risks seen with some oral pain medications. It can be repeated annually for persistent symptom relief if deemed beneficial by the doctor.

Coverage And Costs

In Canada, provincial public drug plans and private insurance often cover the costs of viscosupplementation when administered by a qualified physician for eligible patients with knee OA. However, the rules for reimbursement vary between provinces and private plans. While some may require tried and failed conservative treatment first or limit to certain brands or injection cycles per year. Patients are advised to check their specific coverage policies in advance.

The average total cost of a full viscosupplementation treatment ranges between $500-800 depending on the number of injections required as per the product used. This is generally considered to be a very cost-effective treatment option when we consider it helps delay more expensive interventions like surgery down the line for many patients. Doctors typically recommend a follow up after 6 months to evaluate symptoms response and decide on continuation if needed.

Viscosupplementation with HA injections provide a minimally invasive and effective alternative for managing knee osteoarthritis pain in Canada. When administered properly under medical supervision, it presents an excellent first-line treatment option or an adjuvant to other therapies before considering joint replacement. With sufficient clinical evidence and reimbursement coverage, more patients can benefit from this safe and cost-effective approach. 

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About Author:

Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc.  (https://www.linkedin.com/in/ravina-pandya-1a3984191)