Are injections effective for knee arthritis?

A brief about Arthritis

Osteoarthritis is a degenerative condition of knee joint which advances with age and is characterized by weakening of bones, loss of movements, friction, pain and inflammation. 

What are the various kinds of injections?

·         Cortisone injections

·         Vissco supplementation

Working mechanism for injections

Hyaluronic injections 

Hyaluronic acid is normally present in the knee joint cavity to make the cartilage float and also acts as shock absorber of the joint cavity by preventing the bones from external stresses. These injections are given in a concentrated form and are injected directly into the joint cavity to improve lubrication and range of motion. Studies suggest that there was relief in pain to many patients but at the same time few patients also reported of adverse events like flare ups. This procedure is known as ‘vissco supplementation’.

Corticosteroid injections

Cortisone injections work on fighting the inflammatory process and swelling in the joint cavity. These are intra articular injections and provide considerable short term relief to the patient while also encouraging functional independence at the same time after reduction of swelling. Giving cortisone therapy must not be made a habit and is strictly not to be repeated frequently.

How important is patient selection?

Based on combined study reports, the researchers have found that there have always been individual differences between various patients when it comes to pain, severity of joint damage, erosion of bony ends, age and gender of the patient.

Moreover it should be taken into consideration that the beneficial effects of injection can only be enjoyed by those patients who are relatively independent and are suffering from mild to moderate knee pain andosteoarthritis.

 At this stage of disease, the patients will only seek resolution to pain and swelling. The efficacy of these injections is certainly enhanced when they are given at the appropriate time, when there are not enough or big pieces of cartilage dislodged in the knee joint and when the physician makes an absolutely accurate formulation to be given as per the patient needs.

Advantages

The advantages of steroidal or non steroidal injections are more confined to people leading an active lifestyle since these are the patients who need an immediate pain relief for knee osteoarthritisand cannot afford to take bed rest. The few advantages are:

•          Immediate pain relief.
•          Quick resolution of inflammation and redness around the joint.
•          There is no need for bed rest or acute hospital care.
•          One can get back to work in a short time.
•          There is less difficulty in performing everyday chores.

What are the associated risks?

•          There is no improvement in joint anatomy.
•          Risk of swelling and pain soon after injection.
•          Patient can have an acute flare up reaction.
•          There is a risk for adverse systemic problems like musculoskeletal or cardiac disturbances and disability which can lead to prolonged hospitalization.