From Jonathan Cluett, M.D.,
Your Guide to Orthopedics.
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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Treatment of arthritis has focused on surgery for severely arthritic joints. The non-operative treatments have been less extensively investigated, and there has only been limited success with these treatments. The current mainstay of non-operative treatment for arthritis is focused on the reduction of pain, primarily with the use of nonsteroidal anti-inflammatory (NSAID) medications. Unfortunately, these medications are not ideal for many patients because of side effects; furthermore, there is a suggestion of possible progression of disease with these medications (1).

What is the probelm with arthritis?
Arthritis is one of the most common diseases in the world today. The total cost of this condition has been estimated to be as high as 1% of the gross national product in the United States (2). The knee is among the most commonly involved joints with arthritis, and can be one of the most serious affecting many aspects of an individual's quality of life. Patients with arthritis of the knee are susceptible to complications from other medical conditions, as they are more likely to live a sedentary lifestyle and are more often obese. Effective treatment for knee arthritis is a priority of orthopedic surgeons.

How does Synvisc fit in to arthritis treatment?
One possible method for treating arthritis of the knee without performing surgery has been with an injectable medication called Synvisc (the generic name is Hylan, and sold under the trade name "Synvisc"). Hyaluronan, the name of the substance in Synvisc, is secreted by cells in the cartilage of joints. Hyaluronan is one of the major molecular components of joint fluid, and it gives the joint fluid, also called synovial fluid, its viscous, slippery quality. The high viscosity of synovial fluid allows for the cartilage surfaces of joints to glide upon each other in a smooth fashion. By injecting Synvisc in a knee, some people consider this a so-called joint lubrication. This is why you may hear of Syvisc as a 'motor oil' for the knee joint.

Does Synvisc help knee arthritis?
Numerous studies have been performed in the past decade to assess the effectiveness of Synvisc as a treatment for osteoarthritis. However, no clear understanding of how well Synvisc injections perform has emerged. Early studies of Synvisc were performed on too few patients and the follow-up period was limited to a short time. Some studies showed a benefit of Synvisc injections, primarily in reduction of pain as assessed by patients, when compared to patients getting a placebo-a saline injection (2,3). But to contradict these studies, other trials showed no benefit to the Synvisc injections (4,5).

Read on about Synvisc injections...