An arthritic knee can be extremely limiting to any active person. Hiking can become a chore, running can lose all its fun and getting on the hill to ski can be regrettable for days after taking off the boots. As with any pain, most people will turn to the classic remedies: rest, ice, compression and elevation. When the simple treatments aren’t cutting it, over the counter NSAIDs or Tylenol can provide some relief. Over time, however, these medications can lose their effectiveness. Injectables may be the solution.

In the office, knee arthritis is one of the most common issues we treat. After the more conservative treatments have failed, we turn to injectable medications to help an arthritic knee feel better. There are several medications that we use:

Corticosteroid injections:

A corticosteroid is a medication that mimics our body’s natural hormone cortisol. By injecting a corticosteroid into the knee joint, the medication controls the inflammation caused by the bone on bone contact.  For most stages of arthritis, corticosteroid injections work great to eliminate painful symptoms and allow a person to return to their activity, but they provide a limited timeframe of pain relief.

Viscosupplementation:

A viscosupplementation injection is a type of medication that helps lubricate the rough and worn cartilage surfaces that are rubbing against one another. Joint fluid contains hyaluronic acid, a critical substance that helps “grease” the joint. As a knee becomes more arthritic, the hyaluronic acid breaks down and joint fluid loses some of its beneficial function. Viscosupplementation injections work to replace the lost hyaluronic acid and nourish the worn cartilage surfaces. There are a multitude of different brand names (Synvisc, Supartz, Euflexxa etc.), but they all work in a similar manner.

PRP injections: 

Platelet Rich Plasma (PRP) is your own blood plasma that has been enriched with your own blood platelets. In the office, blood is drawn and spun in a centrifuge separating out the blood platelets. The platelets, with some blood plasma, is then able to be put into a syringe and injected straight into the joint. These types of injections have not only been shown to alleviate painful symptoms, but can also benefit the healing process within the arthritic joint. The whole process takes about an hour and the benefits can last for months.

We are always looking for the next step in the treatment of knee arthritis and one of these injections may be the answer. Knee arthritis doesn’t need to be the end of being physical activity. At your office visit we can discuss the options and select the treatment that is best for you.

Authors: Dr. Richard Cunningham, M.D. is a board-certified, fellowship-trained orthopedic surgeon and knee and shoulder specialist with Vail-Summit Orthopaedics. Matt Vinnal, ATC, is an athletic Trainer to Dr. Cunningham.