Gel Shot For Knee Pain

In Two Groups Of Patients One Group Gets Prp And The Other Group Gets Cortisone How Did This Comparison Work Out

In this study from The Journal of Sports Medicine and Physical Fitness, a comparison is made between the effects of a one-time injection of PRP and corticosteroid for the patients suffering from osteoarthritis.

• Patients suffering from Grade II or Grade III knee osteoarthritis were randomly divided into two groups: intraarticular injection of PRP and cortisone.
• Forty-one participants were involved in the research .

Compared to the group treated with corticosteroids, PRP showed significant results for:

• being symptom-free
• activities of daily living and quality of life

This study demonstrated that one shot of PRP injection, decreased joint pain more and longer-term, alleviated the symptoms, and enhanced the activity of daily living and quality of life in short-term duration in comparison with the corticosteroid.

Hyaluronic Acid Gel Injections: What To Know

Following the injection of hyaluronic acid gel, a two-day rest period is recommended. After an injection, it is possible that you will experience temporary pain or swelling. You should consult your doctor if the pain or swelling persists or worsens. This medication can be given in up to three injections. Pain at the injection site, fluid build-up in the knee, and allergic reactions are among the side effects of the injection.

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Part of the difficulty for patients is that industry-sponsored research abounds, and can skew data to paint a picture of success for products that wont make a dent in their symptoms. While some unproven products, like certain vitamin supplements, are relatively benign and affordable, viscosupplementation can cost thousands of dollars and present real risks, making for a different calculation, said Cara Cipriano, an associate professor of adult reconstruction at the Perelman School of Medicine at the University of Pennsylvania. Then I think that becomes problematic, she said.

In a 2016 study of patients with knee osteoarthritis treated with hyaluronic acid, patients received an average of 3.6 injections at an average cost of more than $300 per injection. The result is major money, sometimes paid out-of-pocket, sometimes covered by Medicare or insurers, for a dubious treatment. That financial incentive could be driving continued use, she said.

This isnt the first attempt to look at the value of viscosupplementation. And there are other organizations and groups that have performed very thorough reviews of the literature and essentially arrived at very similar conclusions, said Cipriano, chief of orthopedic oncology at Penn Medicine. The American Academy of Orthopedic Surgeons issued clinical guidelines in 2013 and doubled down in 2016, advising against the use of hyaluronic acid injections for patients with knee osteoarthritis.

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We Estimate That 1 In 10 Patients Who We See In Our Clinic Have Already Received Some Type Of Stem Cell Therapy In Another Office They Are In Our Clinic Because The Treatment They Have Received Has Failed To Meet The Patients Expectations Simply One Injection Stem Cell Treatments Are Not Sustainable Pain Relief

People with knee osteoarthritis pain, probably like yourself, go to the orthopedist and hear over and over about their eventual need for a knee replacement. You may have been given a much more critical, we should schedule this knee replacement now, recommendation because it took you a long time to walk from the reception area to the examination room, and all along the way you may have been reaching and lunging for chairs, walls, and counters to use as support and your doctor saw you do it.

You would like to avoid the knee replacement for various reasons, all equally important to you. In your research, you have come upon stem cell therapy. You read through some websites that suggest this simple, possibly one-time injection, will make all your pain go away. This is unrealistic thinking as this is almost never the case. The reason it is almost never the case is that stem cell therapy, even when most effective, requires a comprehensive approach to treatment that includes multiple treatments or the use of Prolotherapy injections into the knees supportive ligaments.

• Please see this article: Why stem cell therapy did not work for your knee pain. Here we discuss that:
• Degenerative knee disease does not happen overnight.
• Healing degenerative knee disease with stem cell therapy cannot be expected to repair decades of wear and tear as a one-time injection treatment.

Am I A Good Candidate

Like any treatment for knee arthritis, some individuals respond better than others. Approximately 50% of patients have a noticeable improvement in their knee function and pain after receiving gel injections3. Much research has been done to understand the characteristics of people who consistently respond well to gel injections for knee arthritis4.

If you are considering getting gel injections for knee arthritis, take a look at the candidacy checklist. This tool is based on a 2011 study4 reviewing past scientific research on the effect of hyaluronic injections on those with knee osteoarthritis. The better candidate you are the more likely you are to have a positive experience. If you want to learn more or feel like this treatment could be for you, discuss your specific situation with your doctor.

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What Are Gel Injections

Gel injections are hyaluronic acid supplements, or a synthetic version of a substance that occurs naturally in the joints. The shots are also sometimes called viscosupplementation, and Synvisc and Hyalgan are two specific brands used for this kind of treatment. Like corticosteroids or cortisone shots the gel injections have anti-inflammatory properties. They also have the additional benefit of working like a lubricant or a shock absorber for a joint knee, hip or other allowing them function properly and without pain.

If you suffer from arthritis, you know that movement and range of motion can be compromised by the condition, making it hard or unpleasant to do everyday activities. When the gel injections are successful, they allow the joint to glide smoothly while moving. Much like cortisone shots, the gel injections can provide a window of pain relief that allows a patient to engage in physical therapy for arthritis. Any kind of shot without physical therapy is likely going to be less effective for the treatment of arthritis in the long-term. Discuss a comprehensive treatment plan with a fellowship-trained orthopedic doctor, who can prescribe physical therapy and gel injections as needed.

Types Of Gel Injections

Viscosupplementation, commonly referred to as gel injection, is an injection into the knee joint with a gel-like substance called hyaluronate, or hyaluronic acid. Hyaluronic acid is one of the naturally occurring lubricants in a healthy knee. According to the Cleveland Clinic, pharmaceutical companies in the United States have developed three main hyaluronic acid-based gels, known by the brand names Hyalgan, Synvisc and Supartz. Some of the injection gels are made from biological sources, while others are created synthetically. The technique of viscosupplementation was approved in 1997 by the U.S. Food and Drug Administration for use in the knee, according to the American Academy of Orthopaedic Surgeons.

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Knee Injections: An Effective Solution To Knee Pain

When you receive knee injections, you can reduce your knee pain and inflammation. One of the most common side effects is postprocedural soreness that goes away quickly. The majority of patients return to normal activity within 24 hours of the injection, and begin to experience pain relief as soon as they get home. You should avoid strenuous activities for at least 48 hours following the injection. In most cases, the pain is relieved within 4-6 months.

Why Medicare Wont Cover Your Hyaluronic Acid Injections

Hyaluronic acid injections are not always covered by insurance, and Medicare only covers them every six months. Before Medicare will cover injections, a doctor must first approve them. Insurance typically does not cover injections of viscosupplementation. The person with osteoarthritis is only eligible for viscosupplementation injections in joints other than the knee if they are intra-articular. Viscosupplementations are only covered if the patient has a verified diagnosis of osteoarthritis of the knee as the initial treatment.

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Is Prp Controversial Yes Is It Effective Also Yes

When it works. Below are many citations and references showing the effectiveness of PRP.

Lets start with the most recent research of the effectiveness of PRP for knee osteoarthritis.

• While an October 2020 study in The Journal of International Medical Research still acknowledges that the clinical efficacy of platelet-rich plasma in the treatment of osteoarthritis remains controversial, their examination of five clinical trials including 320 patients found: intra-articular injection of PRP is an effective treatment for osteoarthritis that can reduce post-operative pain, improve locomotor function, and increase patient satisfaction.
• This is a June 2020 study from the journal Clinical Rheumatology, Here researchers suggested that Intra-articular PRP injection provided better effects than other injections for osteoarthritis patients, especially in knee osteoarthritis patients, in terms of pain reduction and function improvement at short-term follow-up. .
• In a study published in the American medical journal Arthroscopy, medical university researchers suggested that PRP injections were more effective in the treatment of knee osteoarthritis, in terms of pain relief and self-reported function improvement at three, six, and twelve months follow-up, compared with other injection treatments. We are going to show the comparative research below.

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Although Surgery And Cortisone Are Common Randomized Trials Have Failed To Produce Evidence For Their Effectiveness Or How Much They Do Work

Moving forward on that research, a February 2020 review study with the title Medical Reversals in Family Practice: A Review, published in the journal Current Therapeutic Research, Clinical and Experimental offered these points:

• Despite inconsistent recommendations for more invasive treatments, hundreds of thousands in the United States are treated with corticosteroid injections and surgery. Although these practices are common, randomized trials have failed to produce evidence for their effectiveness.
• Because corticosteroids have an anti-inflammatory effect and because osteoarthritis is an inflammatory condition, intra-articular corticosteroids have has been used for several decades, and as many as 95% of rheumatologists use them for osteoarthritis however, in a randomized trial of patients with symptomatic knee osteoarthritis, in which 140 patients were treated with an injection of either triamcinolone or saline every 12 weeks for 2 years, there were no differences in pain between patients treated with triamcinolone or saline. Further, patients assigned to the triamcinolone treatment had a greater loss in cartilage thickness. .
• Many patients are likely better off with a less-is-more approach of low-impact physical activity and strength training exercises than cortisone or surgery.

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Although Surgery And Cortisone Are Common Randomized Trials Have Failed To Produce Evidence For The Effectiveness Of Surgery Or Cortisone Injection Or How Much They Do Work

Moving forward on that research, a February 2020 review study with the title Medical Reversals in Family Practice: A Review, published in the journal Current Therapeutic Research, Clinical and Experimental offered these points:

• Despite inconsistent recommendations for more invasive treatments, hundreds of thousands in the United States are treated with corticosteroid injections and surgery. Although these practices are common, randomized trials have failed to produce evidence for their effectiveness.
• Because corticosteroids have an anti-inflammatory effect and because osteoarthritis is an inflammatory condition, intra-articular corticosteroids have has been used for several decades, and as many as 95% of rheumatologists use them for osteoarthritis however, in a randomized trial of patients with symptomatic knee osteoarthritis, in which 140 patients were treated with an injection of either triamcinolone or saline every 12 weeks for 2 years, there were no differences in pain between patients treated with triamcinolone or saline. Further, patients assigned to the triamcinolone treatment had a greater loss in cartilage thickness. .
• Many patients are likely better off with a less-is-more approach of low-impact physical activity and strength training exercises than cortisone or surgery.

What Is The Best Injection For Knee Pain

Many times someone will reach out to us and ask the simple question: What is the best injection for knee pain? The answer is, the one that works for you.

In this article we will explore:

• Cortisone injections
• Cortisone Knee Injections: In the past, your doctor may have recommended against the use of cortisone because it was clear to him or her that there was knee surgery in your future.
• Cortisone is no longer considered the miracle cure for knee pain and should be used sparingly if at all.
• You need to lose weight so the cortisone injection will work better.
• RESEARCH: Corticosteroid knee injections provided no significant pain relief after two years. Researchers say: Do not give cortisone for knee osteoarthritis.
• Although surgery and cortisone are common, randomized trials have failed to produce evidence for the effectiveness of surgery or cortisone injection or how much they do work.
• Cortisone can make bone on bone worse by thinning out the meniscus. But one injection appears okay.
• Cortisone injections before knee surgery lead to greater post-surgical infection risk.
• The cortisone knee injection debate goes on.
• Cortisone injections five years later, did they make knees worse? Not sure. Maybe no.
• Electrical Stimulation Combined with Corticosteroid Injection.

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Are There Any Side Effects Of Gel Injections For Knee Pain

While the benefits of gel injection treatment for knee pain are significant, it is crucial to know if there are any possible side effects. After getting a gel injection in the knee, you may experience the following:

• Irritation or itching

Most of these side effects resolve within a few days of treatment and are primarily seen in first-time patients. Talk to your healthcare expert if you experience any of the above-mentioned symptoms.

Bone Marrow Aspirate Concentrate Or Bone Marrow Concentrate Type Stem Cell Therapy

Using stem cells taken from a patients bone marrow is becoming a therapy of interest due to the potential of these mesenchymal stem cells to differentiate into other types of cells such as bone and cartilage. This is not a new revolutionary treatment, this treatment has been studied and applied for many years. It is a difficult treatment for some doctors to give. You do need experience in all aspects of the treatment to give the patient the best chance at achieving their healing goals.

Bone Marrow is the liquid spongy-type tissue found in the hallow of bones. It is primarily a fatty tissue that houses stem cells that are responsible for the formation of other cells. These mesenchymal stem cells , also called marrow stromal cells, can differentiate into a variety of cell types including osteoblasts , chondrocytes , myocytes , adipocytes , fibroblasts and others when reintroduced into the body by injection. Bone marrow also contains hematopoietic stem cells that give rise to the white and red blood cells and platelets.

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Ten Patients Underwent Intra

A September 2021 study published in The Archives of Bone and Joint Surgery was designed to compare the effectiveness of intra-articular injection of PRP with hyaluronic acid on mild to moderate knee osteoarthritis.

How the study was conducted:

• Ten patients underwent intra-articular PRP injection and 10 others received hyaluronic acid injection.
• At baseline visit and one, three, and six, and 12 months post-injection, clinical assessments were performed using standardized patient self-reporting scores for pain, function, and disability.
• Physical examinations of the knee, including crepitation and range of motion were performed at each visit.

Results:

• The PRP treatment was ascertained to be safe and caused no adverse effects. Significant improvements in the majority of patients were seen in pain and function.
• The hyaluronic acid injection, however, caused only one months significant improvement in the majority of patient-reported outcomes.
• In the majority of visits, the extent of improvements in pain and function were significantly greater in PRP recipients, compared to hyaluronic acid recipients.
• The ROM in both groups slightly increased after interventions.
• The frequency of coarse crepitation, which was detected in 100% of the patients in both groups at the baseline visit, decreased significantly to fine crepitation at the first follow-up visit in 80% and 40% of the PRP and hyaluronic acid recipients, respectively.

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What Are The Risks For Viscosupplementation Treatment For Arthritis

Most people dont have any problems from viscosupplementation, but a small percentage of people do have problems.

The most common problem you might encounter is a flare-up of your arthritis just after your injection. This might cause additional pain and swelling in the short term. Healthcare providers are still learning about the best techniques to help reduce the chances of this complication.

Less common risks include:

• Allergic reaction
• Pain at the injection site

There is also a chance that the treatment will not effectively help your symptoms. Talk to your healthcare provider about all your concerns. Your own risks may vary according to your medical conditions and where and how often you get injections.

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Amniotic Cord Blood And Placenta Tissue Knee Injections

There is a great amount of misinformation surrounding amniotic stem cell therapy, and umbilical cord blood stem cell therapy.We have never offered these treatments.

The primary reason we do not offer these products is that we did not find them to be more effective or economically viable to the patient than the utilization of the patients own stem cells and because we find simple dextrose Prolotherapy and Platelet Rich Plasma to be effective treatments which, in our observations, yield similar if not better results.

Amniotic stem cells marketed in many chiropractic offices are, in reality, micronized amniotic fluid. The micronization process takes amniotic fluid, freeze-dries it, and then processes it. The process kills the stem cells. NO live stem cells are present. However, growth factor remnants remain.

Many people attend webinars and seminars on the benefits of amniotic/placenta, and umbilical cord stem cell therapy. These seminars are often conducted by a chiropractor whose presentation includes a segment on how the attendees of the seminar have joint pain because their own stem cells are too few, too weak, too feeble, and too old to repair the damage.

The great irony of this argument is if you have been told that your own stem cells are too few, too weak, too feeble, and too old, how does the amniotic tissue then work if it has no new stem cells in it?