INJECTABLE TREATMENT OPTIONS FOR OSTEOARTHRITIS KNEE
Knee injections are commonly used in the management of osteoarthritis (OA) when oral medications and lifestyle measures are insufficient. They can provide pain relief, improve function, and delay the need for surgery. Here’s a structured overview by Dr. Chirag Arora:
TYPES OF INJECTIONS
Corticosteroid Injections
- Mechanism: Potent local anti-inflammatory effect.
- Duration of relief: Usually 4–8 weeks, sometimes up to 3 months.
- Indications: Acute flare of pain, significant synovitis/swelling.
- Limitations: Repeated use (>3–4 times per year) can damage cartilage, weaken tendons/ligaments.
Viscosupplementation (Hyaluronic Acid, HA)
- Mechanism: Restores viscoelasticity of synovial fluid, lubricates and cushions the joint.
- Duration of relief: 3–6 months (sometimes longer).
- Indications: Mild to moderate OA, when NSAIDs fail or contraindicated.
- Limitations: Variable response, expensive, not effective in advanced OA.
Platelet-Rich Plasma (PRP) / Autologous Conditioned Plasma (ACP)
- Mechanism: Delivers concentrated growth factors from platelets to reduce inflammation and stimulate tissue repair.
- Duration of relief: 12–24 months in many patients.
- Indications: Younger, active patients with early OA.
- Advantages: Biological, regenerative potential, Out-patient procedure, single shot mostly.
- SIDE EFFECTS: SPIKE IN PAIN DURING FIRST 3-5 DAYS
OUR GOLD STANDARD OF PRACTICE
Stem Cell / Bone Marrow Aspirate Concentrate (BMAC) / Adipose-derived MSCs
- Mechanism: Provide mesenchymal stem cells that may regenerate cartilage and modulate inflammation.
- Duration of relief: Early studies suggest 1–2 years.
- Status: Still investigational, expensive, not universally approved.
- Indications: Early OA, patients seeking regenerative options.
Key Considerations
- Patient selection: Early/moderate OA (KL GD II/III) responds better than end-stage disease.
- Guidance: Ultrasound-guided injections improve accuracy and outcomes.
- Adjuncts: Always combined with weight management, physiotherapy, activity modification, and oral/topical meds.
Summary:
- Steroids → short-term relief, good for flares.
- HA → medium-term, especially in mild-moderate OA.
- PRP/ACP → biologic option, promising for longer-term relief.
- Stem cells → experimental, costly, long-term potential.
Comparison Table
|
Injection Type |
Relief Duration |
Best for |
Advantages |
Limitations |
|
Corticosteroid |
4–8 weeks (sometimes 3 months) |
Pain flare-ups, swelling, advanced OA with synovitis |
Quick relief, low cost |
Cartilage damage |
|
Hyaluronic Acid (Viscosupplementation) |
3–6 months |
Mild–moderate OA |
Improves mobility, safe, repeatable |
Variable response, costly, less effective in severe OA |
|
PRP / ACP (Platelet-Rich Plasma) |
12-24 months |
Younger, active patients, early OA |
Regenerative, longer relief, safe |
Expensive, protocols vary, mild post-injection pain |
|
Stem Cells (BMAC, Adipose MSCs) |
1–2 years (experimental) |
Early OA, patients seeking regenerative therapy |
Potential cartilage repair, long-term benefit |
Very costly, limited evidence |
Book a consultation with the best orthopedic surgeon in Gurgaon, Dr. Chirag Arora, to explore safe and effective injectable treatments for knee osteoarthritis.
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