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Post-arthroscopic symptoms Print E-mail

The immediate post-arthroscopy period up to six weeks after the intervention is characterised by joint effusion, intense pain and impaired joint function which affect a high percentage of patients. Although these effects are mainly due to surgical trauma, a significant secondary cause is that the irrigating solution used during the surgery flushes the synovial fluid out of the joint space, resulting in the so-called “dry joint.” It can take several days for the joint to replace the synovial fluid, resulting in a loss of the protective viscoelastic properties of the hyaluronic acid that is an essential component of this fluid. In addition, the irrigating solutions used are often not physiological and may have a negative effect on cartilage metabolism.

Consequences of the loss of hyaluronic acid from the joint

  • As hyaluronic acid is no longer present, there is no viscoelastic shock absorption or lubrication in the joint, leading to stiffness and pain upon load bearing.
  • The protective hyaluronic acid coating of the cartilage and synovial membrane is washed away, leaving these structures open to inflammatory mediators and mechanical damage.
  • The pain receptors in the synovial membrane are no longer masked resulting in increased pain.
Synovial fluid is flushed out of the joint during arthroscopy

Aiding recovery after arthroscopy

Following arthroscopy, administration of hyaluronic acid acts as a temporary subsitute for the synovial fluid, restoring normal physiological functions. A solution of hyaluronic acid:

  • restores lubrication and shock absorption by replacing the synovial fluid
  • helps to prevent further damage by covering and protecting the joint structures
  • ameliorates pain experienced by the patient
  • reduces swelling
  • promotes joint recovery

In addition, administration of hyaluronic acid displaces any irrigating solution left in the joint space, preventing this solution from impairing cartilage metabolism.


Instilling VISCOSEAL® into the joint after final lavage A solution of hyaluronic acid substitutes for synovial fluid and removes the remaining irrigating solution from the joint. The VISCOSEAL® remaining in the joint will acts as a replacement for the synovial fluid lost during joint lavage.


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