Arthritic pain has been our nemesis for a long while. Back in the day, it was commonly seen in older patients, but as a consequence of poor and unhealthy lifestyle, arthritic pain has started striking our young. Arthritic pain in the knee joints affects mobility of patients, sometimes even preventing them from simple activities like bending down. Rooster Comb injections are proving to be an effective cure for this chronic pain with their slow moving but effective results.
What are Rooster Comb injections?
Rooster Comb is the most commonly used term for hyaluronan injections used to replace the depleted synovial fluid in the knee joint. The use of the term Rooster Comb comes from the fact that the source material for these injections is derived from combs of roosters. Though the modern injection’s source materials are produced through a biochemical process in a controlled environment, the popular term is still used to address these injections. The injections first made an appearance in the 1960’s, when horse racing was immensely popular and race horses involved in accidents suffered severe injuries. Hyaluronic acid obtained from rooster combs and umbilical chords was then purified, to be injected into race horses with injuries. Hyaluronic acid as an agent for viscosupplementation in humans has been discovered recently and is used as an agent to treat mild and moderate osteoarthritis in the knee joint.
How are rooster comb injections formulated?
There are several variations in the formulation of the hyaluronan injections which includes,
– Hylan G-F20 (Synvisc)
– Sodium hyaluronate (Supartz)
– Sodium hyaluronate (Hyalgan)
– 1% Sodium hyaluronate (Euflexxa)
– High-molecular-weight hyaluronan (Orthovisc)
– 1% Sodium hyaluronate (Nuflexxa)
The products listed above are derived from the combs of roosters; the hyaluronic acid then obtained is converted into non-inflammatory hyaluronan through isolation and purification. The viscosupplementation agents available in the United States are Synvisc (Biometrix, New Jersey), Hyalgan (Sanofi, New York) and Supartz (Seika-gaku, Massachussetts). The Food and Drug Administration in the US and Canada deems viscosupplements as medical devices and not drugs, avoiding complicated regulation procedures and felicitating easy availability.
How do Rooster Comb Injections work?
The hyaluronic acid is a polysaccharide chain made of repeating disaccharide units of N-acetylglucosamine and glucuronic acid. In cases of osteoarthritis, the hyaluronic acid concentration is reduced, causing less activity between the acid molecules. The decrease in activity amongst the acid molecules, in turn leads to the synovial fluid between the joint losing its elastic properties and a drop in its viscosity too. The depletion of synovial fluid in the joint leads to stress and friction between bones which might permanently damage the cartilage and cause pain. The cause of this pain is the reduced elasticity of the synovial fluid which is responsible for absorbing shock during fast movements and lubrication during slow movements. The hyaluronan injections are directly administered into the knee to replace the depleted synovial fluid and function as a substitute causing temporary pain relief to osteoarthritis patients.
How are Rooster Comb administered?
The injections are directly inserted in the knee joint of the patient suffering from osteoarthritis. The injections are administered either in one or both the knee joints as per the physician’s discernment. The number of injections to be administered depends on the severity of the disease. Patients who undergo treatment notice relief within the first week or two after the first dosage. The results are a bit slow moving and hence patients need to be tolerant. The effects peak at 5-9 weeks after treatment and may last up to six months to 12 months. The treatment may involve a onetime injection or a course of weekly injections for three to five weeks.
Who can be treated?
Viscosupplementation through hyaluronic injections is currently available only for the knee joint. Hence patients suffering from osteoarthritis in the knee can be injected with the dosage. The drug is used as an alternative treatment for patients who have not found relief through physical therapy, exercise, heat and cold therapy and over-the-counter pain relievers. These injections are recommended for patients suffering from mild to moderated osteoarthritis and not for those with severe cases as they may be ineffective towards these.
Rooster Comb Injections Side effects / risks to be expected
The injections have been duly tested and approved by the Food and Drug Administration and hence are recommended as a safe option for those who want relief from osteoarthritic pain.
– Swelling
The most common side effects noted amongst several patients after the administration of the injection are the local reactions of the knee like swelling, warmth and pain. According to a study by Dr. Chen AL and collaborators from the New York University – Hospital for Joint Diseases, USA, granulomatous inflammation was observed in six patients after an injection of Hylan G-F 20 viscosupplementation agent. Each patient was reported to have had pain, swelling and warmth within 48 hours after the injection. The swelling was noticed to have resolved in 1 to 2 weeks.
– Risks to people with allergy to chicken
The source of these injections is the rooster comb or its biochemical derivatives and hence it cannot be used on patients who are allergic towards poultry or eggs. It is a duty of the patients to bring it to their healthcare provider’s notice of any such allergies present, so as to avoid an anaphylactic shock. As of now, Euflexxa has been proven to be safe for use against people with egg and poultry allergies.
– Ineffectiveness
One of the risks of opting for the hyaluronic injections is that they sometimes may not be effective against your condition. The pain relief provided by these injections is not long lasting and fades away quickly forcing patients to look for permanent options.
Though a very viable treatment option, it must be noted that these injections are an effective way of decreasing the knee joint paint but they cannot actually cure it. So this can be a great option if you are considering a surgery or some other more permanent solution and need time to make your decision. Currently insurance agencies in the US don’t cover viscosupplementation as a part of treatment for osteoarthritis.
