There are a variety of treatments to relieve the symptoms of osteoarthritis in the knee. In arthritis, the surface of the bone becomes damaged. This damage can cause swelling, stiffness, pain and disability. One treatment option is to inject corticosteroids into the knee. Corticosteroid injections can be useful for treating flare-ups of osteoarthritis and help relieve symptoms by reducing inflammation in the joint. Injections may be beneficial for people who are unable to take non-steroidal anti-inflammatories (NSAIDS), and for people who have not had relief from NSAIDs (voltaren, ibuprofen, celebrex, mobic).

The procedure

  • You will be seated with your legs hanging over the side of the examination table.
  • The skin will be prepped with an alcoholic chlorhexidine.
  • The surgeon may use a needle to draw out any extra fluid that is in your knee.
  • The steroid is mixed with local anesthetic and injected, usually just below your kneecap.
  • Generally the injection is not painful
  • A small bandaid is applied to the injection site.

What to expect after the injection

  • you are able to drive
  • the local anaesthetic generally wears off in 2-3 hours. You may experience some pain and discomfort. Paracetamol (panadol/panamax) is advised to relieve discomfort initially.
  • the steroid effect usually works within 24 to 48 hours
  • applying ice to the area (not directly on the skin) can be beneficial
  • rest the affected area for 24 hours
  • avoid strenuous activity for several days
  • the pain relief lasts from 6 to12 weeks
  • steroid injections are not considered a long term solution

PRP (Platelet Rich Plasma Injections) & Durolane Injections

There are some patients that may benefit from a more complex injection than a simple steroid injection.  PRP involves taking some blood, extracting the platelets, and then injecting 3-5ml of platelets into the joint or tendon.  The broad principles above apply.  Durolane is a synthetic lubricant of joints (hyaluronic acid) like your body usually produces.  If the joint is very swollen, the existing fluid is removed before injecting the new.

Durolane and Synvisc are occasionally used for arthritic joints.  They cost approximately $500.  80% of patients feel that they have a worthwhile result for six months or more.  Patients with an egg allergy cannot use Synvisc.  Again, the broad principles above apply.