Post-Hyaluronic Acid Injection Knee Inflammation

Knee inflammation after hyaluronic acid injection?

A 58-year-old male experienced degenerative arthritis between April and May of this year.
Following the doctor's advice, he received three consecutive injections of hyaluronic acid in both knees.
However, after the third injection, about a week later, the knee pain became more severe than before, and he was unable to bend his knees.
During a follow-up visit, the doctor noted fluid accumulation and recommended aspiration, while also promoting various dietary supplements.
Due to the unclear explanation from the doctor, he would like to inquire about the following: 1.
Shouldn't the hyaluronic acid injections lead to improvement? Why has the condition worsened? 2.
If the fluid accumulation is left untreated, will it resolve on its own? 3.
If the fluid is aspirated, does that mean the previously injected hyaluronic acid will also be removed? Thank you.

TINA, 50~59 year old female. Ask Date: 2010/06/01

Dr. Wang Zikang reply Orthopedics

In response to the administration of hyaluronic acid injections in the knee joint, it is unlikely to exacerbate pain.
Generally, the side effects and complications associated with hyaluronic acid injections in the knee joint are minimal.
If there are no allergic reactions after the first injection, it is rare for discomfort to increase.
However, if there is fluid accumulation in the joint cavity, please pay special attention to the following: 1.
Check for any redness, swelling, warmth, or pain around the joint; 2.
Additionally, assess whether the aspirated fluid is cloudy, yellow, or green, and whether there is a fever; 3.
The aspirated fluid should be sent for laboratory testing to confirm that it is not an infection.
Please seek prompt medical attention if any of these symptoms occur.

Reply Date: 2010/06/01

More Info

Post-hyaluronic acid injection knee inflammation can be a concerning issue, especially for individuals suffering from osteoarthritis. Your experience of increased pain and swelling after receiving hyaluronic acid injections is not uncommon, and it raises several important questions about the treatment and its effects.

1. Why did the pain worsen after the hyaluronic acid injection?
Hyaluronic acid injections are intended to provide lubrication and cushioning in the knee joint, potentially alleviating pain and improving mobility. However, some patients may experience an inflammatory response following the injection. This can occur due to several reasons:
- Injection Technique: If the injection is not performed correctly, it may irritate the joint or surrounding tissues, leading to increased pain and inflammation.

- Volume of Injection: An excessive volume of hyaluronic acid can cause distension of the joint capsule, resulting in discomfort and swelling.

- Underlying Conditions: If there are pre-existing conditions such as synovitis (inflammation of the synovial membrane), the injection may exacerbate the symptoms temporarily.

- Body's Reaction: Each individual’s body may react differently to the injection, and some may experience a temporary flare-up of symptoms before improvement occurs.

2. Will the excess fluid (effusion) resolve on its own?
In some cases, mild effusion may resolve spontaneously as the body reabsorbs the excess fluid. However, if the effusion is significant and causing pain or limited mobility, it may require intervention. The body can manage small amounts of fluid, but larger accumulations may lead to increased pressure in the joint, resulting in further discomfort. Therefore, monitoring the situation is crucial, and if symptoms persist or worsen, medical evaluation is warranted.

3. Does draining the fluid mean losing the injected hyaluronic acid?
When fluid is aspirated from the knee joint, it is possible that some of the hyaluronic acid may also be removed along with the excess synovial fluid. However, the primary goal of the aspiration is to relieve pressure and pain caused by the effusion. The amount of hyaluronic acid lost during this process may not be significant enough to negate the benefits of the injection, but it can vary based on the volume of fluid present and the technique used during aspiration. After the procedure, the remaining hyaluronic acid can still provide some level of lubrication and cushioning, but the overall effectiveness may be reduced.

In summary, while hyaluronic acid injections can be beneficial for many patients with osteoarthritis, they are not without risks and potential complications. It is essential to have open communication with your healthcare provider regarding your symptoms and treatment options. If you continue to experience significant pain or swelling, consider seeking a second opinion or discussing alternative treatments that may be more suitable for your condition. Additionally, lifestyle modifications, physical therapy, and other non-invasive treatments can also play a crucial role in managing osteoarthritis symptoms effectively.

Similar Q&A

Does Hyaluronic Acid Injection Affect MRI Results for Knee Issues?

After experiencing knee pain and swelling following exercise, a diagnosis of osteoarthritis was made by a rehabilitation specialist. After more than six months of rehabilitation, the doctor administered hyaluronic acid injections, which did not yield any results. To confirm the u...

Dr. Shi Guozheng reply Orthopedics
There will be no impact.

Managing Osteoarthritis: Hyaluronic Acid Injections and Rehabilitation Tips

Hello Dr. Shi, I am the one who previously inquired in post #195715. Recently, after considering your advice, my mother decided to rest and take medication. However, last week, she suddenly experienced severe pain in her left knee, making it impossible for her to walk. We immedia...

Dr. Shi Guozheng reply Orthopedics
If there is inflammation of the ligaments or tendons near the knee joint, corticosteroid injections can provide improvement. In cases of joint degeneration, hyaluronic acid injections may be beneficial. For joint pain, anti-inflammatory medications can be taken to alleviate sympt...

Post-Operative Care for Knee Arthroscopy: Is Rehab Necessary?

Hello Dr. Chang, My mother underwent a left knee arthroscopy at the end of July this year and has recently received hyaluronic acid treatment. However, she has not been feeling well since the surgery (there is no redness, swelling, heat, or pain). I would like to know if this i...

Dr. Zhang Jiahao reply Orthopedics
Hello: The findings during knee arthroscopy are very important. Possible intraoperative findings include cartilage softening or damage, meniscal tears, or soft tissue proliferation, among others. Different intraoperative findings determine the surgical approach and outcomes. The ...

Understanding Knee Pain After Joint Replacement: Causes and Relief Options

Your partner had a knee replacement due to a car accident and did not undergo rehabilitation at that time. Now, nearly 10 years later, they are experiencing frequent knee pain and discomfort, especially due to physically demanding work. The pain may worsen with changes in weather...

Dr. Shi Guozheng reply Orthopedics
After artificial joint surgery, regular follow-up is necessary. X-ray examinations should be performed in the first year, second year, and fifth year. The causes of pain may include overuse, inflammation, wear, or loosening of the joint. A physician's examination is essentia...