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Dancing the Chicken: Can Rooster Comb Therapy Help Your Arthritic Knees?

Seventeen years ago, a knee injury left Karen, then a 27-year-old mother of two, unable to squat down to pick up her children’s toys. As her children grew and became more active, additional complications and the onset of osteoarthritis further limited Karen’s mobility.

After years of treatment to alleviate pain and remove debris from the joints, Karen, now 44, looks forward to dancing the Chicken at her son’s wedding this summer thanks to hyaluronan — a treatment derived, ironically, from rooster combs.

Hyaluronan, a recently approved therapy for patients with arthritis of the knee, is injected directly into the damaged joint. It cushions and lubricates the knee the same way synovial fluid — secreted naturally by the lining of the joint — does. While undergoing treatment, patients receive three to five hyaluronan injections over the course of several weeks.

"These injections work like brake fluid in your car by lubricating the parts to prevent them from grinding against one another as they move. The treatment may help reduce pain and improve mobility," said William D. Abraham, orthopedic surgeon, with Tri Rivers Surgical.

Osteoarthritis, the most common form of arthritis, is the breaking down or wearing away of cartilage in the joint. Cartilage, a smooth, slick tissue, covers the ends of the bones and helps them glide against one another while in motion. Synovial fluid provides additional cushioning and lubrication to the cartilage-covered bones.

Regular wear and tear, the aging process or trauma can eventually lead to osteoarthritis. In a weight-bearing joint like the knee, daily strain can contribute to increased pain and limited mobility.

Hyaluronic treatment may benefit patients with mild to moderate osteoarthritis who have not responded to traditional therapies, including physical therapy, exercise, over-the-counter pain relievers, prescription medications and steroid injections.

"While hyaluronan therapy has been beneficial for many patients, it does not help everyone, and patients with advanced osteoarthritis may not benefit at all," Dr. Abraham said. "It does not cure osteoarthritis, stop the progression of the disease or heal worn cartilage, but hyaluronan may temporarily improve pain and stiffness in many patients."

Patients usually notice some relief within the first week or two after their initial injection. The effects typically peak five to nine weeks after treatment and may last for six to 12 months.

"Within the first few days following the first treatment, I felt some improvement," Karen said. "Following the subsequent injections, 90 percent of my pain has alleviated, I can walk easier and sleep better at night."

Serious side effects are rare, but because hyaluronan is derived from rooster combs, patients with allergies to eggs or shellfish cannot receive therapy.

With the aid of hyaluronic injections, Karen and others who suffer from osteoarthritis can enjoy the freedom to spread their wings and move again.

What’s all the crowing about?

Hyaluronic therapy has been approved by the Food and Drug Administration for use in patients with arthritis of the knee. Also called viscosupplementation, hyaluronan is injected directly into the knee, where it cushions and lubricates the joint to provide temporary relief of arthritic pain.

"Hyaluronan injections can be repeated once a year in most patients. The treatments are meant to provide temporary relief, however, and do not fix the underlying medical problem. Patients will eventually need to explore other more permanent therapies," Dr. Abraham said.

At this time, hyaluronic therapy is only approved for use in the knee, though it is being considered for use in other joints.