Is manipulation of osteoarthritic knees helpful?

Q: Does manipulation of osteoarthritic knees help? Is hylan injection for visco supplementation safe? My mother is on asprin, clopidogrel and several other medicines. She had an episode of TIA, and is hypertensive. Will it have any adverse effects?

A:Manipulation is usually done for loss of range of motion. It doesn't help in the long run, but can help if there is an acute situation, i.e. early loss of motion. There are no contraindications to hylan except allergies to rooster, chicken etc. The side effects include synovitis and psedoseptic reactions, especially with the cross-linked preparations (synvisc) but have not been reported with non cross-linked (supartz, etc.)