1. What exactly is Hyaluronic Acid?
Hyaluronic Acid is a natural sugar molecule -known as a polysaccharide or a glycosaminoglycan, found in almost all species in various parts of the body. Its highest concentration is found in the synovial fluid of our joints also in our skin and eyes. High concentrations exist especially in the knee joint as the knee joint is the major weight-bearing joint in our body.
2. What is the function of Hyaluronic Acid in our body?
In the joint spaces, it acts as a lubricant and cushions the joint. It also acts as a “scaffold protein”, which allows our own or injected stem cells (into our joints for osteoarthritis or degenerative arthritis), to have a structured mesh to cling to.
This greatly enhances the efficacy of stem cell therapy, especially in the knees. Hyaluronic Acid is used in the world of cosmetics as powerful skin hydration. It is also used for certain eye conditions.
3. What happens to Hyaluronic Acid as we age?
It dramatically decreases, which is one reason why when we age our joints, skin, and eyes degenerate. This degeneration is greatly enhanced by:
- Obesity (especially in our weight-bearing joints which are knees, hips, and spine)
- Lack of sleep
- Inflammatory diet
- Type 2 diabetes
- Or anything that produces oxidative stress or free radical production
All of this will accelerate the loss of Hyaluronic Acid and the breakdown of our joints, skin, and eyes.
4. What are the different ways to replenish Hyaluronic Acid in our bodies?
Certain serums and supplements or a diet high in Hyaluronic Acid are typically used for cosmetic purposes. Joint viscosupplementation is always done by an injection containing highly concentrated Hyaluronic Acid.
Taking supplements or eating food high in Hyaluronic Acid does not adequately fuel levels to make positive changes in arthritic joints.
5. What are the different sources of Hyaluronic Acid for joint injections for arthritic joints?
There are basically three sources for joint injections and one is far superior to the others. First of all, Hyaluronic Acid injections used for arthritic joints are commonly known as gel injections, hyaluronan, or viscosupplementation.
It is very important to learn that not all Hyaluronic Acid sources are created equal.
The first source of Hyaluronic Acid comes from a rooster comb. This source is synthetic, has a higher molecular weight and can cause unwanted immune responses after the injection due to certain proteins known as avian proteins. This is an older form or Hyaluronic Acid injection and unfortunately, many clinics are still using this.
The second source is a large amount of Hyaluronic Acid in the human umbilical cord, found in an area known as Wharton’s Jelly. This is also the best source of mesenchymal stem cells used for arthritic joint regeneration (which is what we use at Beyer Stem Cell Institute).
The fact that there is Hyaluronic Acid in Wharton’s Jelly of the human umbilical cord is very convenient. The reason is that as mentioned before, it works in tandem with mesenchymal stem cells by acting as a scaffold protein or a mesh. Thus, it greatly impacts the regenerative powers of mesenchymal stem cells.
Unfortunately, in very degenerative joints (especially the knees), the Hyaluronic Acid found in human umbilical tissue may not be sufficient to assist the regenerative powers of mesenchymal stem cells. Additional injections of Hyaluronic Acid may be required. Which brings us to our 3rd source.
The 3rd source of Hyaluronic Acid is from extraction and purification from the fermentation of bacteria. The extreme benefit to this is that this form is identical in chemical composition to human Hyaluronic Acid so there is no immune reaction. The Hyaluronic Acid product we use at Beyer Stem Cell Institute comes from this method. The product is known as Genvisc 850 from OrthogenRX Research shows that Genvisc 850 is as safe as injecting saline solution into the joint (see studies at the bottom of this article).
6. Why should Hyaluronic Acid be used in conjunction with umbilical cord tissue and mesenchymal stem cells?
Hyaluronic Acid by itself is more of temporary relief of arthritic joint pain, it DOES NOT regenerate new tissue. Mesenchymal stem cells potentially will regenerate joint tissue such as cartilage, ligaments, etc. and is extremely anti-inflammatory.
The two together work synergistically and last much longer than Hyaluronic Acid by itself. A study done by the National Institute of Health concluded the following, “The efficiency of mesenchymal stem cells combined with Hyaluronic acid has been found to be superior to those of mesenchymal stem cells and hyaluronic acid alone.”
If utilizing Hyaluronic Acid were comparable to watering and fertilizing a bad lawn, then stem cells are like adding new grass seed to the lawn.
7. Why does Beyer Stem Cell Institute use Genvisc 850 for its Hyaluronic Acid therapy?
- It’s a non-synthetic, non-Avian source because it comes from the extraction and purification of Hyaluronic Acid from the fermentation of bacteria. This makes it identical in chemical structure to human Hyaluronic Acid.
- There is no immune response nor adverse reaction
- It is the most researched Hyaluronic Acid product in the world. There are over 30 research studies supporting its safety and effectiveness. I’ve included several of these studies at the end of this article.
- There have been over 50 million dosages administered worldwide since its approval. This product is formerly known as Adant.
- It is approved in over 60 countries and has never been withdrawn in any market for safety concerns.
8. How is Hyaluronic Acid administered for arthritic joints? What is the treatment protocol?
The treatment is delivered by joint injection. Typically, there are a series of five weekly injections. Some experience relief after one injection and usually by the 3rd injection but five weekly injections are strongly recommended.
We also recommend avoiding heavy sports activities like jogging, tennis, or heavy lifting for 48 hours after the injections. These injections can be done every 6 months.
9. When will I feel relief and for how long will the relief last from Genvisc 850 Hyaluronic Acid injections?
The studies for Genvisc 850 done alone WITHOUT stem cells show that relief is possible after just one injection. Most will feel relief after three injections, but five injections are strongly recommended. Additionally, a particular study shows that relief can last as long as 30 weeks with five injections.
Again, this study is done without regenerative medicine and stem cell therapy. The results can last much much longer with stem therapy in addition to Genvisc 850 Hyaluronic Acid therapy, along with properly done at-home range of motion exercises.
10. Is Genvisc 850 FDA approved?
Yes, Genvisc 850 is FDA approved, however for KNEES ONLY. Using Hyaluronic Acid injections for other joints can be discussed.
11. Is Genvisc 850 Hyaluronic Acid covered by insurance?
Yes, our offices accept Medicare and Blue Cross Blue Shield. Blue Cross Blue Shield may be subject to deductibles and copays. Medicare and Blue Cross Blue Shield will only cover Genvisc 850 for arthritic knees.
12. What is the out of pocket expense if I desire Genvisc 850 Hyaluronic Acid?
If you do not have Medicare or Blue Cross Blue Shield, and/or want treatment for another joint besides your knee, you have the option to pay out of pocket. The cost is $500 per injection or five injections would cost $2400.
Additionally, Beyer Stem Cell Institute does offer Care Credit financing. The cost for 12 months (interest-free) would be $200 per month. Alternatively, the cost for up to 48 months (with interest) would be $70 per month.
Approval for Care Credit financing can be done in person in our office. If you live out of town, our staff can guide you through the approval process from your home.
Below are some studies on Hyaluronic Acid and specifically Genvisc 850
Intra-articular Treatment with Hyaluronic Acid. Comparative Study of Hyalgan and Adant
Clin Rheumatol (2000) 19;204-206
Intra-Articular Hyaluronan Treatment of Patients with Knee Osteoarthritis Waiting for Replacement Surgery
The Open Arthritis Journal, 2008, 1, 1-7
A 40- month multicentre, randomized placebo-controlled study to assess the efficacy and carry over effect of repeated intra-articular injections of hyaluronic acid in knee osteoarthritis: the Amelia project
The efficacy and safety of sodium hyaluronate injection (Adant) in treating degenerative osteoarthritis: a multi-center, randomized, double blind, positive-drug parallel-controlled and non-inferiority clinical study
International Journal of Rheumatic Diseases 2015
A method for establishing class III medical device equivalence: sodium hyaluronate (GenVisc 850) for the treatment of knee osteoarthritis
Medical Devices: Evidence and Research
Single versus multiple dose hyaluronic acid: Comparison of the results
Journal of Back and Musculoskeletal Rehabilitation 29 (2016) 881-886
If you’re suffering from arthritis, joint pain, or any other chronic condition that causes pain, reach out to our team in Tinley Park today!
If still have questions, you may find more answers in this link to our blog page.