Knee injections: Your questions answered

In this article, Mr Amit Shah, a consultant trauma and orthopaedic surgeon discusses frequently asked questions about knee injections.

What are knee injections?

Knee injections are medications which are injected into the knee joint. They are used as rapid, temporary relief from painful symptoms which are caused by knee oesteoarthritis (also known as wear-and-tear arthritis) and can also decrease inflammation in the knee. Knee injections are available in a variety of different products. The top three products available at the moment are steroids, hyaluronic acid injections and platelet-rich plasma (PRP) injections.

What conditions are treated with knee injections?

There are multiple conditions which can be treated with knee injections. Treatment options vary based on what you want to treat. The most common options are as follows:

• Steroids- these reduce pain and inflammation.
• PRP (platelet-rich plasma) injections- these introduce the patient´s own platelets into the area of injury. This allows the redevelopment of cells which will help regenerate new cartilage (the shock absorbing surface of the bones).
• Viscose supplements- these help lubricate the joints. An example is hyaluronic acid.

How are knee injections given? Are there any side effects?

Knee injections can be given in a clinic environment, using aseptic precautions, with a surgeon who is trained in putting a needle right in the middle of the knee joint. Aseptic precautions are practices which protect patients from healthcare-related infections and also protect healthcare workers from contact with body fluid, body tissue and blood.

There are some risks of side effects from using knee injections but they are extremely minimal and occur in less than 1 in 1000 patients.

There is a very small risk of infection and of damage to nerves or vessels. Additionally, there is also a small risk of having an allergic reaction to the products of the injection. However, this is not very common.

What recommendations should patients follow after receiving knee injections?

The recommendations for patients following knee injections depends on the type of injection used and how frequently the injections are to be repeated.

Most surgeons recommend to rest for a day or two after injections to avoid flare ups. After this rest period, a gradual return to normal activity is recommended.

Some injections must be repeated at a later date and can take a variable amount of time to kick into action.

Are knee injections a good alternative to knee surgery?

Knee injections are not an alternative to knee surgery but they supplement the treatment options available to us. They are an appropriate option for early stages of arthritis or knee problems.

However, they are not an appropriate option when knee arthritis becomes quite severe. For severe cases of arthritis, knee injections would probably be a waste of the patient´s time once surgery becomes indicated.