Knee Arthritis Injections: Staying on the Court and out of Pain By: Brian Larkin, MD
Nowadays, you cannot turn on the TV, open the newspaper, or surf the web without being bombarded with all sorts of options for injections in painful, arthritic knees. Many options promise quick pain relief and improved function. Below is a brief summary of the options that exist.
Steroid injections. Steroid (cortisone) injections target the inflammation present due to knee arthritis. These are commonly combined with local anesthetic and provide predictable pain relief. Patients can get these about every 3-4 months as needed. There is a possibility that multiple injections into a single joint may lead to degradation of the tissues present there.
Viscosupplementation injections. Viscosupplementation injections are composed of hyaluronic acid. Hyaluronic acid is a component of synovial fluid, the cushioning liquid in the knee. These medications are derived from the comb of a rooster. Trade names include Synvisc, Orthovisc, Gel One, Euflexxa, Monovisc, and many others. Insurance providers may approve these injections every 6 months. In the setting of advanced arthritis, certain patients do not get much relief with these shots.
Platelet-Rich Plasma (PRP). Platelet-rich plasma is a portion of a patient’s own blood. Blood is drawn out of the patient’s vein and then spun down to concentrate the platelets and growth factors. This concentrated solution is then injected back into the knee joint. Professional athletes have sought these types of injections with the goal of decreasing inflammation and enhancing the healing process. PRP injections are not currently covered by most insurance plans.
Stem cell injections. Stem cell injections have been gaining more excitement in the lay press about the potential to reverse arthritis. Unfortunately, there are no strong studies that support the idea that stem cell injections into the knee can regrow cartilage and reverse arthritis. Some are able to get relief from the injections due to an anti-inflammation effect. There are a number of sources where the stem cells can be harvested and multiple different preparations that exist. It is important to ask your provider about these details. Similar to PRP injections, these are not currently covered by most insurance plans.
As you can see, there are a number of options that exist. In order to tailor the treatment of any patient’s knee arthritis, a detailed discussion with your orthopedic surgeon that covers your symptoms, x-ray findings, and goals of treatment should be had on a regular basis. The goal is to minimize your symptoms and keep you on the court playing at your top capacity. Through our shared partnership between Orthopedic Associates and the Colorado USTA, we are committed to educating our patients about all of these options and tailoring each patient’s specific treatment plan.