INJECTION THERAPY

Hyaluronic Acid Ultrasound Guided Injections for Osteoarthritis

Ultrasound guided Injection therapy is an effective treatment as part of a rehabilitation programme.

Swansea Health Solutions offers the treatment of Ostenil® Plus injections, administered on-site by our Osteopath and MSK Sonographer Gareth Davies.

The administration Hyaluronic is an advanced skill that requires extensive post-graduate training in injection therapy and ultrasonography.

What is osteoarthritis?

Osteoarthritis is the most common form of arthritis in the UK. (See facts below). Knees, hips and small joints in the hand are the most frequently affected areas but osteoarthritis can occur in any synovial joint in the body. Osteoarthritis is a condition that causes joints to become swollen, stiff and painful. It often makes carrying out everyday activities particularly difficult for those who suffer from it. Ostenil® Plus injections are designed to treat the symptoms of osteoarthritis. Injections can be administered in the knee, hip or any other joints that are classified as ‘synovial.’

What is a synovial joint?

A synovial joint is one in which the ends of the bones are joined together and enclosed in a capsule containing a thick, slippery liquid called synovial fluid, for example the hip, knees and shoulders.

Main functions of synovial fluid are:

•    Protecting their cartilage coverings from wear and tear.
•    To absorb shock, protecting the cartilage.
•    To lubricate the joint, helping it to work freely and easily.
•    To act as a filter, allowing for nutrients to reach the cartilage and preventing the passage of harmful cells and substances.

The most important component of synovial fluid is a substance called hyaluronic acid, which allows for synovial fluid to perform these important functions at the same time.

Ostenil® Plus injections – what are they and how can they help?

Hyaluronic acid injections are licensed for use in any joint in the body (except the spine). Patients who are active particularly favor these injections as they work to nourish and lubricate joints mimicking the body’s natural synovial fluid. The benefits from the HA injections can be noticeable 2-3 weeks after the injection. You will gradually experience a reduction in pain and stiffness and this improvement will likely persist for up to nine months, depending on the progression of the degenerative change in the joint being treated.

How does OSTENIL work?

Ostenil® Plus injections consist of a clear solution containing sodium hyaluronate. It’s a pure animal free substance that is completely biocompatible and imitates the lubricates the joint. The injection is administered under Ultrasound, by a fully qualified practitioner, into the space in the joint that contains synovial fluid. It works by restoring the normal balance between the breakdown and production of hyaluronic acid within the joint. HA naturally breaks down in the body during metabolism and is then replaced. However, as we get older and our metabolism slows down, replacement of HA is less often which results in less lubrication and fats.

The antioxidant (Mannitol) plays an important role to eliminate the distressing effects of free radicals on the skin dermis, whilst stopping any gel degradation from occurring and the risk of post-injection inflammation. The effect is that it can decrease pain and stiffness, and improve the other symptoms of osteoarthritis.

Are there any side effects?

The injections have no known side effects, and they are not known to be detrimental to the body’s tissues. There is a very small risk of infection as with any injection and patients may occasionally complain of post injection pain, which may last for a day or two.

Am I suitable for Ostenil® Plus injections?

For further information, costs and to discuss your suitability for treatment,
please call us on 01792 872900

More information on hyaluronic acid injections can be found here:§ion=56

Further evidence from Cochrane reviews (internationally recognized as the highest standard in evidence based health care) has concluded that these types of injections are effective treatments for mild to moderate knee osteoarthritis. It’s unfortunately not a treatment that is offered by the NHS.

For the full review, please visit

The NHS website provides additional information on osteoarthritis and treatments available.

The State of Musculoskeletal Health 2017 provides a resource for health professionals, policy makers, public health leads and anyone interested in musculoskeletal health and states that:

•    An estimated 8.75 million people aged 45 years and over (33%) in the UK have sought treatment for osteoarthritis. 60% were female and 40% were male.

•    Risk of developing osteoarthritis increases with age. A third of
women and almost a quarter of men between 45 and 64 have sought treatment for osteoarthritis, this rises to almost half of people aged 75 and over.137

•    1/3 of people with osteoarthritis retire early, give up work or reduce the hours they work because of their condition.

•    Nearly 3/4 of people with osteoarthritis report constant pain.

•    8.75 million people aged 45 and over
in the UK have sought treatment or osteoarthritis.

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