Another Study Suggests: Repeated Courses Of Treatment With Hyaluronic Acid Are Safe And Are Associated With The Delay Of Total Knee Replacement For Up To 3 Years
A July 2018 study in the American Journal of Orthopedics recognized that for some people: Total knee replacement is a significant procedure with potential risk for serious complications and high costs. Alternative lower risk therapies that can delay or total knee replacement are valuable to those who are poor candidates for surgery or wish to avoid total knee replacement as long as possible.
Are Hyaluronic Acid Injections the answer? Here is what the study concluded:Repeated courses of treatment with Hyaluronic Acid are safe and are associated with the delay of total knee replacement for up to 3 years. So again, we have a three-year delay after repeated courses of Hyaluronic Acid injections supported in the research. But what about the study that says Hyaluronic Acid Injections that delay inevitable knee replacement are a waste of time, money, and resources?
How Do You Prepare For A Gel Shot
It is best to prepare for the treatment by discussing your symptoms and severity of your joint pain with your doctor. There should be clear communication speaking about the procedure and what to expect. Prior to the appointment day, you will have discussed with your physician any specifics you have about the injections.
Gel shots are usually recommended for patients when less invasive treatment options have not provided relief. Gel shot injections can be administered within a standard doctors office visit.
Cautions With Other Medicines
There are many medicines that can affect the way hydrocortisone injections work.
It’s very important to check with your doctor or pharmacist that a medicine is safe to mix with hydrocortisone injections before you start having them.
This includes prescription medicines and ones that you buy like paracetamol, ibuprofen and aspirin. It also includes herbal remedies and supplements.
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How Often Do You Need Knee Injections
How often you need a knee injection depends on several factors. Some of them include:
- Medical history
- Stage of your condition
- How long your relief lasts
A corticosteroid injection may provide relief for up to 24 weeks, while a hyaluronic acid injection may last 12 to 24 weeks. Corticosteroid injections can only be administered once every three to four months. Thats because they can break down your cartilage and come with possible side effects including high blood pressure, osteoporosis, and skin atrophy.
In comparison, hyaluronic acid injections may not work for everyone, and how theyre administered varies depending on the manufacturer. To determine the best solution for your osteoarthritis, talk to your doctor about the risks and benefits of each injection.
Research Comparing Prp Bone Marrow And Adipose
A July 2020 study published in the journal Clinical Medicine Insights Arthritis and Musculoskeletal Disorders, compared platelet-rich plasma , bone marrow aspirate concentrate, and adipose-derived mesenchymal stem cell injections in the treatment of osteoarthritis of the knee using functional scores.
- Methods: A total of 89 patients with painful knee osteoarthritis were included in this study.
- Patients were assigned to one of the 3 treatments according to the severity of osteoarthritis as indicated by symptoms and radiography to PRP , bone marrow aspirate concentrate , or adipose-derived MSC .
- Clinical assessment was performed using standard scoring systems, Surveys were completed at preoperative, and at 90, 180, and 265 days post-treatment.
Results: They all worked well.
- In a general statement, the PRP worked just as well in stage 1 knee osteoarthritis patients as the bone marrow aspirate worked in the stage 2 knee osteoarthritis patients and the adipose-derived stem cells worked for the stage 3 knee osteoarthritis patients. To quote the researchers: Our findings support previous reports and encourage further research on the use of these cost-effective treatments for osteoarthritis of the knee.
This is also a validation of our policy of not going straight to stem cell therapy in some of our patients. PRP or Prolotherapy, which is discussed below can provide equally good results without the added expense.
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What To Expect After A Hyaluronic Acid Injection
Everyone responds to hyaluronic acid injections a little differently. You might have almost immediate relief, or it could take a few weeks for the inflammation and pain in your knees to subside. Soon you find that you can move more easily and without pain.
Most patients have pain relief for 4-6 months. You can have hyaluronic acid injections every six months or so. Many patients find that the injections provide enough relief that they can delay or even avoid knee replacement surgery.;
This is especially important if you had a traumatic knee injury in the past, which can increase your risk of early-onset osteoarthritis. Joint replacements last for 10-15 years. With a current average life expectancy of over 72 years, if you can delay a knee replacement, you can avoid additional knee replacement surgeries later in life.;
If you have knee pain thats interfering with your life and want to find out if hyaluronic acid injections can help, .
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What To Expect After Corticosteroid Or Hyaluronic Acid Injections
Most people can return home or to work immediately after the injection takes place. The site of the injection may be swollen or tender for one or two days. Doctors may recommend applying ice two or three times a day or taking an over-the-counter medication to relieve pain and reduce swelling.
It may take several weeks to see improvement after a hyaluronic acid injection. Our doctors recommend restricting high-impact activity, such as running, until symptoms improve.
A person may feel the pain relief effects of corticosteroid injections more quickly than hyaluronic acid, but the results may not last as long. However, each person may respond differently to either of these injections.
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What To Expect From A Knee Injection
It was the 50s when famous comedian, Jack Benny, received an award and opened his acceptance speech with, I dont deserve this award, but I have arthritis, and I dont deserve that either. Since then, advancements in medicine and technology have provided relief for millions of people with arthritis, but more than 100 different types of arthritis and related conditions still impact Americans today.
One of the more serious conditions is osteoarthritis. Thats because the chronic condition worsens over time deteriorating cartilage and causing pain and swelling. While there is no way to reverse the damage, todays medical advancements make it possible to retain cartilage or replace the tissue with a more stable solution such as a partial or total knee replacement surgery. But, surgery isnt right for everyone, and sometimes injections are a better alternative. What are they, and what can you expect from a knee injection?
Other Injections: Hyaluronic Acid Botox And More
Some people have used other types of injections for OA of the knee.
However, experts from the American College of Rheumatology and the Arthritis Foundation dont currently recommend using these, as theres not enough evidence that they work.
Examples of other types of injections include:
- hyaluronic acid injections, also known as viscosupplementation
You may not know exactly what type of injection youre receiving or what the effect might be.
Always discuss the pros and cons of any treatment with your doctor before starting, so that you can make an informed decision.
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Who Can And Cannot Have Hydrocortisone Injections
Most adults and children, including babies, can have hydrocortisone injections.
Hydrocortisone injections are not suitable for some people. Tell your doctor before starting the medicine if you:
- have ever had an allergic reaction to hydrocortisone or any other medicine
- have ever had depression or manic depression or if any of your close family has had these illnesses
- have an infection
- are trying to get pregnant, are already pregnant or you are breastfeeding
- have recently been in contact with someone with chickenpox, shingles or measles
- have recently had, or you’re due to have, any vaccinations
Hydrocortisone injections can make some health problems worse so it’s important that your doctor monitors you.
Make sure your doctor knows if you have:
If you have diabetes and monitor your own blood sugar, you will need to do this more often. Hydrocortisone injections can affect your blood sugar control.
Hyaluronic Acid Injections Or Viscosupplementation For Knee Osteoarthritis
Much like cortisone, it is very likely that this knee injection treatment has been explained to you already by your orthopedist. It is a conservative care plan to help you try to manage along until you can get a knee surgery scheduled or you are trying to do everything you can to avoid the knee surgery.
Also like cortisone, you may have already had viscosupplementation and the effects and benefits have now worn off and you need to treat your knee differently. For some people, they may not even be reading this sentence because they have moved down the article to other treatments because this one is no longer an option for them.
What is Hyaluronic acid injections or Viscosupplementation?
The explanation that you may have been given is that hyaluronic acid injections will provide a gel-like cushion in your knee, getting between the shin and thigh bones to alleviate your bone-on-bone situation. The injections increase the volume of the protective synovial fluid in the knee.
- The treatment is therefore referred to as Viscosupplementation because you are supplementing the viscosity or the thick, sticky, gel-like properties of the synovial fluid. Hyaluronic acid is naturally occurring in the synovial fluid of the knee.
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What Are Gel Knee Injections
Our bodies naturally produce a thick gel called synovial fluid that keeps our joints lubricated and properly functioning. In patients with osteoarthritis, this gel becomes watery as the cartilage in your knees breaks down and is no longer effective in protecting your joints and absorbing shock.
Doctors can temporarily restore this substance into arthritic knees via gel shots. This treatment increased the hyaluronic acid levels in your knees to that of fully functioning joints. Once this fluid is restored, patients can experience reduced creaking, grinding, and inflammation, as well as restored function in their knees and most of all, pain relief.
What Are The Side Effects Of Viscosupplementation Injections
The most commonly reported side effects associated with the injections are temporary injection-site pain; swelling, heat, or redness; rash and itching; bruising around the joint; and fluid accumulation in the injected knee. These reactions are usually mild and don’t last long. As with steroid injections, infection and bleeding are also rare complications.
Talk to your doctor about viscosupplementation if you have osteoarthritis and have not found pain relief from other means such as exercise, physical therapy, weight loss, use of heat and cold, use of a cane or other product that relieves pressure on the knee, use of pain relievers, or steroid injections.
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You Can Delay Knee Replacement Realistically For About 11 Months With Hyaluronic Acid Injections
In September 2020, a study in the journal American Health and Drug Benefits, assessed the value of intra-articular hyaluronic acid injections monetarily. This is a way to determine the effectiveness of the treatment. This is what the study said:
Although limiting hyaluronic acid use may reduce knee osteoarthritis-related costs, in this study hyaluronic acid injection only comprised a small fraction of the overall costs related to knee osteoarthritis. Among patients who had a knee replacement, those who received treatment with hyaluronic acid had surgery delayed by an average of 10.7 months.
What Happens After The Injection
Some soreness is common in the first few days after the shot. Apply ice to the area to relieve pain. Other possible side effects include infection, nerve damage, skin discoloration and weakening of nearby bones . But these are rare.
Within one to four days after you get the injection, the steroid should kick in and start providing relief. The duration of pain relief varies based on the severity of the arthritis.
If were seeing a patient early on, when they have mild-to-moderate changes inside the knee joint, they have a much better chance of the injection lasting a long time, Golnick says. The effects of the injection can last for three months or more in someone with mild-to-moderate arthritis, but those with more severe arthritis could have a return of symptoms within a few weeks.
You can repeat the injections once every three or four months, but no more than four times a year. Overdoing it on steroids could actually hasten joint damage, Golnick says. If corticosteroids stop working, you could try another type of injection, such as hyaluronic acid .
Steroid injections provide temporary relief from arthritis pain, but theyre not a long-term solution. In most patients, arthritis is going to progress. Eventually, treatments that are working today will probably lose effectiveness, Golnick says. Thats when patients start looking at joint replacement surgery to help them with their pain and discomfort.
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Why Might I Need Viscosupplementation Treatment For Arthritis
You may have already tried other treatments for your arthritis, like over-the-counter pain medicines and corticosteroid injections. If you still have significant symptoms, viscosupplementation might be a good choice to help reduce your pain, stiffness, and swelling. The treatment seems to work best in people with mild or moderate arthritis. The treatment may particularly make sense if you are trying to delay getting surgery on your joint.
Generally, healthcare providers use viscosupplementation to treat osteoarthritis, but the technique may also benefit people with certain other kinds of arthritis, like rheumatoid arthritis. You can talk to your healthcare provider about whether it is a choice for your type of arthritis.
Hyaluronic acid injection is not a treatment choice for arthritis in all types of joints. The knee is the standard injection site, but you might also be able to get it for arthritis in your hip or possibly in another location.
Can You Walk With No Cartilage In Your Knee
If left untreated, the joint, especially if it is a weight-bearing one, such as the knee, can eventually become so damaged that the person cannot walk. Apart from immobility, the pain may slowly get worse. All small articular cartilage defects can eventually progress to osteoarthritis if given enough time.
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Rated For Osteoarthritis Report
Had both knees injections done on July 14, 2021. Next day both knees where swollen with fluid on my knees & couldnt walk. I wait till a week no change, contacted my Dr and immediately she had me come into the office to drain my knees & inserted cordisone. Next day my knees were normal again. I dont recommend this product.
Caring Medical Research Prolotherapy For Knee Pain
In published research in the Journal of Prolotherapy, Ross Hauser MD investigated the outcomes of patients receiving Prolotherapy treatment for unresolved, difficult to treat knee pain at a charity clinic in Illinois.
- 80 patients, representing a total of 119 knees, were treated quarterly with Prolotherapy.
- The results of this study showed that patients had a statistically significant decline in their level of pain, stiffness, crunching sensation, and improvement in their range of motion with Prolotherapy.
- More than 82% showed improvements in walking ability, medication usage, athletic ability, anxiety, depression, and overall disability with Prolotherapy. Ninety-six percent of patients felt Prolotherapy improved their life overall.
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How Effective Are Hyaluronic Acid Injections For Osteoarthritis
Studies show hyaluronic acid injections may work better than painkillers for some people with OA. Other studies have shown they also may work as well as corticosteroid knee injections.
Hyaluronic acid injections seem to work better in some people than others. They may be less effective in older adults and people with severe OA.
What Type Of Knee Injection Will Help 6 Options For Chronic Knee Pain
Are you looking for relief from your knee problem and youre thinking that an injection might help you out. In this video today, Ill be discussing the six types of knee injections that are out there, the costs associated with them, and also how long you can expect to get relief from each one.
My name is Dr. David Middaugh, and Im a specialist physical therapist at El Paso manual physical therapy. On this channel, we help people stay healthy, active and mobile, while avoiding unnecessary surgery injections and pain medications. please consider subscribing so that you dont miss out on any of the helpful videos that we post every single week when we get into the six injections next.
But stick around to the end of the video because Im going to give my opinion about what I think of each injection when you shouldnt get them at the beginning here. Im just going to give you the information for each injection as objectively as I can without giving you my opinion. Ill save that to the end.
They usually fast acting so you can expect to get relief within a day or two of having the injection. And the cost of a cortisone injection is usually anywhere from 100 to $200 each injection. Now there are some side effects of cortisone injections. They do tend to break down ligaments, tendons, cartilage, and even bone.
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What Are The Differences Between Gel Shots And Corticosteroid Shots
Corticosteroid, or steroid injections, are another treatment option recommended by the American College of Rheumatology to improve joint function. ;These injections include corticosteroid medication and a local anesthetic. They are most effective in treating inflammatory conditions, such as rheumatoid arthritis, bursitis, gout, plantar fasciitis, psoriatic arthritis, reactive arthritis.
Corticosteroids sometimes also referred to as cortisone injections can help relieve pain and reduce inflammation in the body including ankle, elbow, hip, knee, shoulder, spine, and wrist. Like gel shots, steroids are injected directly into the joint space and can reduce pain more quickly.
Steroid injections will provide more immediate relief from pain with a faster recovery, but the relief will be more short term.
Steroid treatment is used with caution for diabetes because steroids can raise blood sugar levels. Additionally, there could be an adverse effect of this treatment for prolonged use and to those allergic to corticosteroids. In these instances, viscosupplementation may offer an alternative treatment for joint pain relief.