Steroid

Hyaluronic Acid (HA)

Platelet Rich Plasma (PRP)

Treatment

The doctor will inject steroids combined with analgesic into the knee. It might feel hot or pressured, but it relieves pain and inflammation rapidly within 24 – 48 hours. The treatment can last as long as 12 weeks. However, you should not get more than 4 injections per year.

The doctor will inject hyaluronic acid or lubricants that will act as a cushion between the knee joints so that the bones will not rub against each other. This treatment can last 3 – 6 months and can be reinjected as necessary and under the doctor’s guidance.

The doctor will inject the patient’s own platelet-rich plasma, which has been processed to separate out the red blood cells and white blood cells. The PRP contains platelets and growth factors at high concentration enough for treatment. There might be swelling and some pain afterwards. The number of injections depends on the doctor’s recommendation.

Advantages

Steroids can block the inflammation process in specific tissue or location. It can act quickly and reduce inflammation within 24 – 48 hours.

HA injection can help reduce pain and inflammation. Movement is better and the patient can regain their quality of life.

PRP will induce growth factors to repair and build new tissue faster than normal healing process. The fluid will reduce friction and pain as well as mend bones, joints, tendons, and muscles in the body.

Recommendation

• – Patients who suffer from inflammation.
• – Patients who do not respond to medications.
• – Patients who cannot take pain medications.

• – Patients who suffer from knee ostheoarthritis in the early to moderate stages.
• – Patients who do not see improvement after medication and physical therapy.
• – Patients who do not have clear inflammation that qualifies them for steroid injection.
• – Patients who are waiting to get surgery or not ready for knee replacement surgery.
• – Patients who cannot have knee replacement surgery.

• – Younger patients in the early stages of knee ostheoarthritis whose cartilages are not too damaged.
• – Patients who suffer from knee ostheoarthritis in the early to moderate stages.
• – Patients who do not see improvement after medication and physical therapy.
• – Patients who are sensitive to NSAIDS, such as ibuprofen.
• – Patients who cannot get steroid injection.

Possible Side Effects

• – Damage to surrounding tissue from steroid injection.
• – Skin thinning and discoloration.
• – Increased chance of infection. Doctor will examine around the area of injection and take careful medical history of allergic interaction with steroids prior to treatment.

The knee may swell and become painful due to inflammation during treatment.

The knee may swell and hurt within the first 3 days of injection. Patients should wait weeks or months before the next injection as recommended by the treating physician.

Precautions

• – Patients should not have infection in or around the affected knee.
• – Patients should not have adverse effects to steroids.

Since hyaluronic acid tends to be extracted from avians, it is recommended that patients do not have allergies to eggs or avians. Please inform the doctor before receiving treatment.

• – Prior to treatment, patients should avoid using medication or steroids for 2 –3 weeks and refrain from using NSAIDS for at least one week.
• – Patients should not take anti-coagulant at least 5 days before treatment.

Limitations

Steroid injections will have the best effects the first few times, but they are not recommended for long-term treatment. This is because steroids will interfere with nature healing. Thus, the treatment does not work well after a while, alternative methods should be considered.

• – HA injection takes longer time to reduce pain than steroids.
• – Older patients or patients with severe knee osteoarthritis will have deformed cartilage and are not recommended for HA injections.

Patients with severe knee osteoarthritis, patients with severe inflammation and infection, patients with hematologic conditions or excessive bleeding that requires anti-coagulants, patients with anemia or pregnant women are not recommended to get PRP injection.