Viscosupplementation treatments (rooster injections/chicken shots) of the knee are very reasonable, scientific treatments for knee pain. These injections are covered by most insurance policies for arthritic knee pain every six months and are easily performed in the clinic setting with very little pain. While not specifically indicated for other human joints, the principles on which the treatments are based apply to every joint in the body. Clinical reports have indicated similar pain relief when hyaluronic acid (HA) preparations are used in the setting of hip, shoulder and ankle arthritis pain. HA injections replace a valuable molecular component of the articular fluid called hyaluronic acid (HA) that is either produced from rooster comb or recombinant DNA technology where bacterial molecular machinery is hijacked and used to make human HA that is then purified for delivery in pre-packaged sterile syringes for administration.
These injections have almost no side effects. Following injection, the molecule itself can no longer be found in the joint fluid after four days leading to speculation regarding mechanism of action. The lay media often credit HA with a reduction in friction and improving the lubricant properties of the knee as the responsible mechanism for relief. More likely, relief comes when HA complexes with another known molecule called tumor necrosis stimulated gene protein 6 (TSG-6) that is not produced in the normal knee. The TSG-6/HA complex inhibits production of matrix metalloproteinases (MMP-3, MMP-6 and MMP-9), preserving extracellular matrix (ECM) and cartilage. Most scientific literature supports an anti-inflammatory and immune modulating effect that generally lasts approximately six months.