Ask a Vail Sports Doc column: Do injectable treatments help an arthritic knee?
November 28, 2016
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 nonsteroidal anti-inflammatory drugs — such as ibuprofen or aspirin — or Tylenol can provide some relief. Over time, however, these medications can lose their effectiveness. Injectable medications 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 time-frame 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.
• Platelet-rich plasma injections: Platelet-rich plasma, or 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, are then put into a syringe and injected straight into the joint.
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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 physically activity. At your office visit, we can discuss the options and select the treatment that is best for you.
Dr. Rick Cunningham is a knee and shoulder sports medicine specialist with Vail-Summit Orthopaedics. He is a physician for the U.S. Ski Team and president of Vail-Summit Orthopaedics. Matt Vinnal, ATC, is an athletic trainer to Cunningham. Do you have a sports medicine question you'd like him to answer in this column? Visit his website at http://www.vailknee.com to submit your topic idea. For more information about Vail-Summit Orthopaedics, visit http://www.vsortho.com.
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