ROOSTER COMB INJECTIONS- WHAT IS IT? DO THEY WORK? AM I A CANDIDATE?
What are Rooster Comb Injections?
Dr. Saenz Response: Rooster comb injections are actually a byproduct or constituent of the little red thing on the rooster’s head. Known as the rooster comb, from which, the substance hyaluronic acid is extracted.
The first generation of products were actually derived from the rooster comb. It was the very first product used and coined as a ‘viscosupplement’. There are a whole host of second-generation products that are non-avian — meaning they are not derived from the rooster any longer.
The second-generation has been derived from bacterial sources. There are strains of bacteria that do beneficial things for us in the world of medicine and healthcare management. So hyaluronic acid — again being the active ingredient derived from the rooster comb — is now capable of being fermented from that bacterial source.
So there are probably more products on the market now that are being utilized that come from the bacterial source and not the rooster comb.
Viscosupplements are FDA approved products for the treatment of osteoarthritis of the knee.
What are Rooster Comb Injections Commonly Used to Treat?
Dr. Saenz Response: There is one sole indication for treatment right now that is approved by the FDA. That is through the management of osteoarthritis of the knee.
What Areas Can Rooster Comb Injections be Used?
Dr. Saenz Response: Osteoarthritis of the knee isn't really any different than that of the ankle or the shoulder. It's a disease that affects the articular cartilage, which is the protective cartilage over the bone.
When articular cartilage becomes degraded or eroded (from injury, wear and tear, age-related, or genetic reasons), that is osteoarthritis. So, in a very broad sense, these rooster comb injections can be injected into any joint. We could likely expect to see the same effect.
But in truth, there is only one indication, and that is for injection of the supplements into the knee. That’s the only thing that the FDA has approved them for at this point in time.
Who is a Candidate for Rooster Comb Injections?
Dr. Saenz Response: Any individual that has been clinically diagnosed by a physician as having osteoarthritis of their knee.
Why Choose Rooster Comb Injections Over Other Injection Types?
Dr. Saenz Response: Traditionally the other injection would have been a steroid, cortisone.
Cortisone injections do have a role in the management of osteoarthritis. But it’s effects are going to go over a definable period. It's used as a method of putting out the fire, so to speak, of osteoarthritis. These injections are used for treating those individuals that are in an osteoarthritis flare. However, this isn’t expected to produce long-term benefits.
Viscosupplements, like the rooster comb injections, work differently. They work at rejuvenating what is referred to as the synovial fluid. Synovial fluid is the natural lubricant that we have in our joint that reduces friction. So that is how hyaluronic acid or rooster comb injections work. They rejuvenate and restore the volume and viscosity of someone's synovial fluid.
What are the Side Effects and Down-Time for Rooster Comb Injections?
Dr. Saenz Response: The individual who receives this injection is instructed to avoid any high impact activity like intense exercise or intense job activities. This is to preserve those molecules and allows them to bind to the receptor sites on the synovial cells.
The typical time frame for avoiding any of those high-impact activities is 48 hours following the injection.
When Can I Experience Pain Relief and How Long Will It Last?
Dr. Saenz Response: Typically, this synovial rejuvenation process is thought to take somewhere between 4-7 weeks. So we have to counsel our patients to not look for an immediate benefit. They shouldn't expect a cortisone-like improvement where relief is seen within 3-4 days. So it’s a little longer of a process.
You have to take into account the severity of arthritis in that individual. It may last 6 months in one person and it may last 2 years in another person. Based on the studies, we tell our patients to expect benefits for at least 6 months.
Does Insurance Cover Rooster Comb Injections?
Dr. Saenz Response: Since rooster comb injections are approved by the FDA, most insurance plans will cover them. However, not all insurance plans will. Since it varies from one insurance company to the next, call your provider before scheduling your appointment.
“In the course of the 15 or so years that I’ve been giving these rooster comb injections (averaging probably administration of 1,000 injections a year), there are many many many patients that are repeat patients who have received multiple administrations. I’ve put them in my own knee for my own osteoarthritis and do so on a yearly basis because of the benefits that are derived.” ~Dr. Paul Saenz, D.O.
How Frequently Can Rooster Comb Injections Be Done?
Dr. Saenz Response: They are approved for repeat administration no sooner than every 6 months by most insurance companies. But there have been really no deleterious effects noted by repeat administration.
What if I Don’t Have Much Cartilage in My Joints?
Dr. Saenz Response: If you don’t have much cartilage in your knee (or whatever joint you’re thinking about receiving injections with viscosupplements), then your prognosis is a little bit more guarded. This is because that’s the more advanced stage of osteoarthritis. You may see diminished or decreased benefits from these types of injections if your disease is more advanced.
Consulting with your orthopedic physician can help you make an educated decision on if this is the right treatment for your specific case of osteoarthritis.
What Determines if I Need Surgery or if This Type of Injection Can Help?
Dr. Saenz Response: Surgery becomes the choice when more conservative measures don’t effectively manage the symptoms. It’d be very difficult to tell a patient who’s got bone on bone arthritis or end-stage arthritis that we can continue to manage their symptoms with non-operative means. That’s not very realistic.
Patients that have comorbidities (like advanced heart disease making them a surgical risk) wouldn’t be a good surgical candidate. Then, by all means, we are going to exhaust every single non-surgical method of treatment there is and that includes these injections.
Don’t let osteoarthritis knee pain hold you back from experiencing the life you crave. Get back to playing club soccer or running around with your grandkids ASAP with rooster comb injections.
Schedule an appointment with Dr. Saenz or any of our Sports Medicine Physicians at Sports Medicine Associates of San Antonio today!