Osteoarthritis is a joint inflammation that results from degeneration of cartilage, bones, muscle, and synovia. As cartilage breaks down, the ends of the bones get thicken; the joint may lose its normal shape, and the ends of bones may begin to rub together, eventually causing harsh pain.

Osteoarthritis mainly affects weight-bearing joints (like the knees). Progressive cartilage degeneration of the knee joints can lead to deformity and outward curvature of the knee, and the patient may develop a limp.
Osteoarthritis is the most common form of arthritis, affecting 8 out of 10 people over the age of 55 and mostly people over the age of 75.

The condition can be caused by aging, heredity, obesity and injury from accidents or disease. Work-related repetitive movement and habitual joint injury may also contribute to the development of Osteoarthritis.

** The change of degeneration.
Degeneration means aging like the hair turns gray and wrinkles appear on the face as gets old.

Hyaluronic Acid and Joints

Osteoarthritis (degenerative arthritis) occurs from changes in the knee joints as the cells that form the cartilage and synovial fluid degenerate with age. Function is thus lowered. The cartilage and synovia in the joint loses their flexibility and cannot protect the joint from impacts and stress. This causes pain in the affected joint that is associated with osteoarthritis.

The changes that occur in the joint are brought about by changes in the quality and amount of the hyaluronic acid (HA) in the joint. Hyaluronic acid is the main component of joint cartilage and synovial fluid. HA shows high viscosity and elastic property, which maintains healthy joints. Sufferers of degenerative arthritis do not produce sufficient hyaluronic acid and accelerated degeneration results in the destruction of hyaluronic acid, decreasing its concentration and molecular weight.

That is to say osteoarthritis patients feel pain their knees as hyaluronic acid in the joints decreases.

4 Stages in Osteoarthritis

Beginning Stage
The surface of smooth cartilage gets rough. The cartilage begins to degenerate because the existing hyaluronic acid is destroyed along with that the amount of newly produced hyaluronic acid decreases. As cartilage and synovia cannot protect the joints, the destruction of cartilage begins. The intervals between the joints remain well preserved.

Middle Stage 1
The surface of damaged cartilage, which should be smooth, gets rougher and newly made bone known as “bone spurs” are formed at the edge of joints. These bone spurs are sharp and they create piercing pain. The intervals between joints wear down unevenly.

Middle Stage 2
As more bone spurs form, patients will feel pain whenever the joints move. Broken bone pieces scratch the synovial membranes and cause inflammation. The joint space between adjacent bones narrows.

Last Stage
The joint space between adjacent bones completely disappears. Bone spurs are large and visible; the cartilage has disintegrated. The bones are exposed to each other.

How is osteoarthritis treated?

Progressive Treatment
An antiphlogistic analgesic relieves pain, makes joint movement easier and has a limited effect on reducing inflammation. However, side effects such as stomach discomfort, body aches and swelling can occur in some people accordingly.

These medications should only be used after consulting with a physician. Steroid injection (injection into the bone) instantly reduces pain and inflammation but repeated injections over a long period can have a negative effect worsen the joint condition. Serious cases of osteoarthritis may require knee surgery.

A new treatment for the pain of osteoarthritis patients is the Hyruan Plus injection. Hyruan Plus is a hyaluronic acid injection with high molecular weight. It is the main component of synovial fluid and cartilage. It is injected directly into the joints, serving as a high viscosity lubricant to make joints move smoothly and give then the elasticity for absorbing the shock of impacts in daily activities.

What is a cartilage injection and how is it different from a steroid injection?

The hyaluronic acid injection, which is injected into joints, is called a cartilage injection. Because it is injected into the knees or joints, it may be misunderstood as a bone injection. This is not the case.
A steroid injection, which is called as a bone injection, reduces inflammation well, alleviating pain. However, the effect is temporary and comes with many side effects.

The amount and duration of pain reduction varies by patients’ condition. Duration can last from 6 months to one year. The Hyaluronic Plus injection is relatively safe and none of the side effects were shown in the whole body. Topical reaction may include pain, pressure pain, and redness at the injection site.

Self-control in Daily Life

Even after the Hyruan Plus injection, patients must visit the hospital regularly to get physical and medical treatment.

- Dip the knees in the hot water and do pressing exercises.
- In case of sudden pain or swelling, apply an ice pack for 15 minutes.
- When standing, be conscious not to strain the knees.
- It is good to wear sneakers or low shoes.
- Do not walk too much, or sit on your knees.
- Avoid activities that twist the knees or feet.
- Try to lose the weight to reduce the burden on the knees.
- It is good to go hiking to strengthen your muscles.
- In order to maintain the strength of the healthy joints exercise such as swimming is recommended.