Boston Red Sox third baseman, Mike Lowell, was put on the disabled list June 28th because of hip pain. This is the same hip that he had surgery on last fall. This Monday, he underwent a procedure where some fluid was removed from the hip joint, and a synthetic joint lubricant, Synvisc, was injected into the joint. Lowell is reported to be feeling better already and hopes to be back shortly after the All-Star break.
The hip joint is a ball and socket joint, where the head of the femur (the bone of the thigh) rests in a round socket in the pelvic bone. It is held in place by a number of ligaments and a joint capsule. The joint capsule is a fibrous membrane lined with a smooth layer called the synovium. The joint capsule contains a fluid, called synovial fluid, produced by the joint capsule’s synovial cells. This fluid acts as a lubricant to allow smooth movement of the joint surfaces. The surface of the bones are also covered in smooth cartilage which absorbs the shock of movement and protects the underlying bone.
Osteoarthritis occurs when the cartilage is broken down- whether by infection, inflammation, or just wear and tear over time. With continued loss of cartilage, the underlying bone can start to rub against itself, leading to more permanent joint damage. Symptoms include pain, swelling, and reduced range of motion of the joint.
There are a number of treatment options, including pain medication, antiinflammatory medications, physical therapy, and combinations of the above. In more severe cases, joint replacement surgery may be necessary.
In Mike Lowell’s case, a synthetic synovial fluid substitute, Synvisc (generic name-hylan G-F 20) was injected into the joint after the withdrawal of some synovial fluid. Synvisc mimics a naturally occurring body substance (hyaluronate) which is a component of synovial fluid. Depending on the particular product, patients receive a series of three to five injections, which are administered directly into the affected knee(s) or hip(s) to help provide temporary relief of pain and flexible joint movement. This treatment is reserved for patients who do not respond to pain/antiinflammatory medications and physical therapy.
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