Saturday, June 27, 2009

3000 Miles or 68 Games.

Mike Lowell will be making his way back to Boston to get an injection of Synvisc in his balky hip on Monday.

Most of the movable joints in the body (hip included) are synovial joints. Synovial joints differ from fibrous joints and cartilaginous joints in how the bones are held together; fibrous joints are held together by fibrous connective tissue and the bones shouldn't be able to move (the bones of the skull are good examples), cartilaginous joints are held together by cartilage and move only a little (where the first rib connects to the sternum is a good example), and synovial joints are two bones that are strapped together by ligaments with some space in between.

Inside a synovial joint the bones are covered with cartilage to lessen the impact of them knocking together during movement. The cavity between the bones is also lined with a membrane, conveniently called the synovial membrane. This membrane secretes synovial fluid into the empty space.

Synovial fluid has a high viscosity and a consistency similar to that of raw albumen. (When you separate a joint--like a knuckle--little bubbles will form in the fluid and when you close the joint the bubbles will pop, creating a satisfactory cracking sound.) Its purpose is to lubricate the joint and reduce friction as the cartilaginous ends of the bones slide across each other. It may also help to nourish the cartilage.

The treatment they're prescribing for Mikey is usually given to patients suffering from osteoarthritis in the knee. It is, essentially, synovial fluid replacement therapy. Hyaluronate (Synvisc being the brand name) injection is similar in concept to an oil change. They inject the treatment into the joint and it protects the cartilage in much the same way that motor oil protects an engine. Hyaluronan (what it's made of) has also been shown to have anti-inflammatory properties, which may help to protect against further damage.

Its effectiveness in patients with osteoarthritic knees is questionable. Some patients have seen no improvement and others have seen a reduction in knee pain for up to six months. But there doesn't seem to be any harm in giving it a shot.

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