Hyaluronic acid injections

Orthovisc T injection
Summary

This procedure is performed for tendinopathies around the elbow, particularly tennis and golfer’s elbow.  The aim of the procedure is to promote a healing response and the regeneration of normal tendon tissue.  

Factors to Consider

Symptoms from tennis or golfer’s elbow vary significantly between patients.  Some patients may have discomfort after strenuous exercise whereas others will have severe pain that prevents them from doing their normal activities.  

It is likely that you have already tried non-surgical treatments for your elbow such as pain killers, activity modification and physiotherapy.   The next logical step would be to consider an injection.  You may have already tried a steroid injection.  Steroid injections usually will give good short term relief (for 6 weeks) but symptoms can return worse than before and harder to treat.  Therefore, it is best to avoid any further steroid injections.

Hyaluronic acid injections are an effective treatment that can be performed in the clinic that avoids the potential side effects that steroid injections have.  

Description of Surgery

The procedure can be performed in clinic.  Local anaesthetic is injected around the point of maximum tenderness.  Hyaluronic acid can then be injected into the affected tendon with minimial discomfort.  The procedure takes about 10 minutes.

What are the risks?

The risk of infection is very small and is thought to be about 0.5%.  Most infections will settle simply with antibiotics.

The main risk is that your symptoms do not fully resolve.  Hyaluronic acid injections seem to be effective in approximately 80% of patients.

After Surgery

Pain

The local anaesthetic will last up to 12 hours but the elbow may be sore after it wears off.  It is important that you take regular pain relief if you need it so that you can start moving your arm early.  

Physiotherapy

The surgeon will refer you to physiotherapy following the procedure.  You should see them within a few weeks of your injection.  

Driving

You can drive when you feel you are safe to drive.  This means that you feel confident that you have full control of your car and are able to swerve out of the way of something in the road.  This will vary between patients but normally takes about a week.  

Return to work

This depends on what your job is.  You should be able to return to a “desk job” straight after  your procedure.  If you have a more manual job it can take up to 6 weeks before you feel ready to return to work.  Please discuss this further with your surgeon or physiotherapist if you feel unsure.  A sick note can be given to you at the time of your surgery if required.  Please ask the nurses on the ward if you need one.

What to expect

Recovery following surgery can be quite variable.  Your symptoms should be improved/improving by 3 months with the majority fully recovered by 6 months.  It can, however, take up to a year for some patients to fully improve.