The biggest fear my patients have isn’t the knee pain itself. It’s the fear of The Surgery. Patients often limp into my clinic at Sparsh (Borivali) or Criticare (Andheri), terrified that I am going to take one look at their X-ray and schedule them for a total knee replacement the next morning.
Let me set the record straight: My goal as an ethical orthopedic surgeon is to keep you OUT of the operating theatre for as long as possible.
Knee replacement is a fantastic procedure, but it is the final step. It is not the first step. For patients with early to moderate arthritis, we have powerful non-surgical options that can buy you years of relief. The most effective of these is Viscosupplementation, often called the “Gel Injection.”
What is the “Liquid Knee” Injection?
To understand this, you need to understand your knee. In a healthy knee, there is a thick, slippery fluid called Hyaluronic Acid. It acts like the engine oil in your car—it lubricates the moving parts and acts as a shock absorber. When you have Osteoarthritis, this fluid dries up and becomes thin. The “oil” is gone, so the gears (your bones) start grinding against each other. That is the pain you feel.
Viscosupplementation is exactly what it sounds like: We are supplementing the viscosity. We inject a high-grade, synthetic Hyaluronic Acid directly into the joint gap. It restocks the “oil,” reducing friction and coating the raw bone surfaces.
Is It Just a Painkiller?
No. This is a common misconception.
- Steroid Injections are powerful anti-inflammatories. They kill pain instantly but can weaken bone if used too often. I use these sparingly for acute swelling.
- Gel (Visco) Injections are distinct. They are a mechanical fix. They improve the environment inside the knee. They don’t just mask the pain; they reduce the friction that causes the pain.
Who Is This For? (The Ideal Candidate)
This injection is not magic. It won’t grow back bone. If you have “bone-on-bone” Stage 4 arthritis, you need surgery. But it is a game-changer for:
- Grade 1 or 2 Arthritis: You have pain when climbing stairs or squatting, but your X-rays still show some gap remaining. The gel can preserve that gap.
- The “Not Ready Yet” Patient: Maybe you have a family wedding next month. Maybe you have a big business trip. You can’t take 3 weeks off for surgery right now. This injection can give you 6 to 12 months of relief, allowing you to plan surgery on your timeline.
- The Medically High-Risk: I have patients who are 85+ with heart conditions or on heavy blood thinners, for whom anesthesia is a risk. For them, this injection is a safe, effective way to maintain quality of life without the stress of surgery.
The Procedure: What to Expect
Patients often ask, “Will it hurt?” or “Do I need to be admitted?”
- Time: It takes 10 minutes in the OPD. No admission. No hospital stay.
- Pain: It feels like a small ant bite, similar to a blood test. I use a local anesthetic spray to numb the skin first.
- Recovery: You walk out of the clinic immediately. You can go to work the same day. We just advise avoiding heavy gym work for 48 hours.
The Trust Factor
Why am I writing a blog about not doing surgery? Because trust is the most important instrument in my medical kit. I perform these injections regularly because they work. If I can relieve your pain with a simple, affordable injection, I will never push you toward a major surgery.
And here is the reality: Arthritis is a progressive disease. Five or seven years down the line, when the injections eventually stop working and you do need that knee replacement, you will feel safe coming to me. You will know that Dr. Govind Baranwal doesn’t operate for profit; he operates for the patient.
Knee pain? Don’t Google it and scare yourself. Let’s diagnose it. Come in for a consultation. If we can fix it with a needle, we won’t use a knife.