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Knee Arthritis


Osteoarthritis is a degenerative joint disease that can cause problems with the knees. Osteoarthritis (OA) is a chronic condition that causes the breakdown of cartilage between the joints. Cartilage serves as a cushion for joints and protects the surface of the bones. Without this cushion, bones can rub or grind together, causing pain, stiffness, and swelling.

Approximately 1 in 5 adults (18.2%) over 45 years of age in England have osteoarthritis of the knee. The prevalence ranges from around 15% to 21% across local authorities in England. The rate of knee replacements in local authority areas ranges from 1/1,000 to 6/1,000 people over 45 years.

Injection Therapy For Knee Arthritis

If a patient continues to experience discomfort, swelling, or extensive joint damage, despite trying conservative treatments, their GP may suggest knee replacement or a knee injection. Doctors will typically recommend knee injection therapy before recommending surgery. For some people, injections help to alleviate knee pain and improve function.

Corticosteroid injections

Osteoarthritis can make everyday life and simple movement difficult. Corticosteroid injections are among the most common knee injections. Doctors and trained clinicians inject corticosteroids directly into the knee joint to help relieve knee pain and inflammation quickly.

They are routinely used to reduce inflammation. Corticosteroids mimic the effects of a substance called cortisol that is naturally produced by the adrenal glands. These are not the same as anabolic steroids used by body-builders to gain muscle mass. Steroids can be taken orally as tablets or given as an injection to joint or soft tissue. The purpose for injecting steroids is to target a much smaller dose more precisely to the area of pain for better result. The injected corticosteroid quickly travels to the inflammation site and provides rapid relief to the inflamed area and is more powerful than traditional oral anti-inflammatory medications and safer than oral steroids as it does not cause many of the side effects that oral corticosteroid medications do.

Steroid can be administered in the clinics. Some people feel almost immediate relief, while others feel the effects several days later. Depending on the condition of the knee, the benefits can last from a few days to more than 6 months. Factors that play a role in how long the effects of the steroid injection will last include the extent of degenerative change and inflammation and overall health. It is important to note that steroid injection is not a cure for arthritis. Additional cortisone injections may be helpful, and up to 3 injections can safely administered over a period of twelve months.

Hyaluronic acid injections

Many patients are being recommended hyaluronic acid injections as a potential alternative to steroid as they are potentially less harmful to the soft tissues in certain conditions and can give pain relief for longer duration therefore requiring less frequent injections.

Hyaluronic acid injections can give many patients some relief of pain for degenerative joint conditions. The improvements, as with any injection, are temporary but can last up to 6-9 months. Hyaluronic acid injections are generally considered to be very safe, although very few people may experience some pain for around 48 hours after the injections.  This usually fully resolves quickly and can be managed with relative rest, cold compress and over-the-counter painkillers.

Hyaluronic acid is a naturally occurring substance within the body which can now be synthesised as a viscosupplement and can be used for treatment by injection into degenerative joints that have become painful. HA injections are often suggested as a safe treatment for people with mild to moderate degenerative osteoarthritis of knee. Some patients may benefit from having a series of injections whereas some injections can be delivered as a single treatment. This can be discussed with our specialist clinicians to decide which is the most appropriate for you.

Fluid Aspiration via Injection (Arthrocentesis)

There is normally a few millilitres (ml) of synovial fluid within a knee joint, which lubricates it for ease of movement through its range of motion. However, inflammation can cause fluid to collect within the knee joint. Arthrocentesis takes the extra fluid out of the knee, which can provide immediate relief from pain and swelling and increased pressure within the knee joint.

Aspirating the joint fluid is also important if your doctor suspects you may have a joint infection. A sample of your joint fluid is taken and sent to a lab for a cell count, culture, and antimicrobial sensitivity.

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