APPLICATION FOR JOINTS

ORTHOPEDICS SPORTS MEDICINE

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GOLDIC® SERUM

INTRA-ARTICULAR INJECTIONS

GOLDIC® serum contains hundreds of different proteins many of which are cytokines and growth factors that have beneficial effects in joints with synovitis and or arthritis. Because of the heterogeneity of GOLDIC® it is difficult ascertain a definitive or single mechanism of action. Potential beneficial effects of GOLDIC® on cartilage, synovium and inflammation have been demonstrated in vitro and in vivo. Inflammation is a key element in the pain and progression of arthritis.

Arthritis is most often referred to joint inflammation, but it is actually a general term for a lot of medical conditions that affect the musculoskeletal system. Symptoms of this condition are pain, stiffness, inflammation and damage to joint cartilage, which can go from mild to severe. The most common types are: osteoarthritis and rheumatoid arthritis. These diseases most commonly affects joints in the knees, hands, hips and spine but it can damage any joint.

All GOLDIC® intra-articular injections are performed as an outpatient procedure. An experienced physician should perform the injections. Using image guidance, such as ultrasound, may be used to ensure a safe and precise placement of the injection into the damaged (glenohumeral, elbow, wrist, finger, hip, knee and ankle) joint.

Thorough understanding of basic injection principles, knowledge of the underlying anatomy, and consideration of the advantages and disadvantages of the imaging approaches should facilitate the selection of the most appropriate technique for any clinical scenario.

A Baker's Cyst

PRECAUTIONS

Pre-Injection Precautions

  • Appropriate patient education and discussion have occurred with an informed consent signed prior to the initiation of the procedure.
  • Avoid corticosteroid medications for 2 to 3 weeks prior to the procedure.
  • Patients are advised to drink plenty of fluids the day before the procedure.
  • Some patients may require anti-anxiety medication immediately before the procedure.

* According to the “American Academy of Orthopedic Surgeons” recommendations.

Injection Precautions

  • All necessary materials for the injection (GOLDIC® set, needles, US gel, etc.) should have been planned and placed on a sterile table adjacent and easily accessible to the physician.
  • A doctor or technician prepares the GOLDIC® for injection and the affected area is cleansed with disinfectant. The patient’s skin is cleansed appropriately and towels or drapes may be used to create an aseptic field.
  • Sterile technique is used, including mask, sterile gloves, and sterile preparation.
  • A lidocaine injection and/or another local anaesthetic may be used to numb the injection site. We have not seen a decrease in the effectiveness of the use of local anaesthetics.
  • In light of safety and efficacy differences between guided and blind injections, we adhere to guided injections as the general standard with GOLDIC ® injections. Individual physician ability and patient preference may alter this choice on a case-by-case base.
  • Appropriate needle gauge and length depend on the joint being targeted. Sterile single-use needles should be used with appropriate handling and disposal.
  • The patient is placed in an appropriate and comfortable position that allows for sterility and access to the site of injection.
  • If local anesthetic will be used, it is to be applied with aseptic technique.
  • If ultrasound is used, apply gel.
  • Once the needle is in the proper position, the GOLDIC® serum solution is then injected intra-articular. Although the serum is injected slowly, most patients sense some pressure due to the amount of the serum used (which is app. 3ml). The pressure of the injection is not generally painful.
  • A typical treatment consists of four (4) 3 ml GOLDIC® serum injections every 2-3 days.
  • For small joints, the same procedure applies, but the amount of GOLDIC® serum used is less (app. 1.5 ml) and smaller needles are used.
  • Apply a dressing or appropriate bandage to protect the needle entry site.

Post-Injection

  • Monitor for post-procedure complications. Important safety considerations include attention to the possibility of bruising and / or soreness at the injection site. The complication rate for intra-articular injections is low.
  • Following the injection, the patient usually remains for 30 minutes to ensure that there are no immediate complications or adverse reactions, such as allergic reaction or leg weakness / numbness. The doctor or other team member will determine when it is safe for the patient to go home.
  • Tenderness at the needle insertion site can occur for a few hours after the procedure and can be treated by applying an ice pack for 10 to 15 minutes once or twice an hour.
  • Patients should be given post-procedure instructions, precautions, and emergency contact information.
  • In addition, patients are usually asked to rest for the remainder of the day on which they have the intraarticular GOLDIC® serum injection.
  • The procedure should be recorded in detail with a procedure note including the date, pre/post-procedure
    diagnosis, procedure title, performing physician w/wo assistants, anaesthesia, a brief indication of procedure, description of procedure including guidance and instruments.

GOLDIC® PREPARATION GUIDE