At INLIVEN, the 3 pillars for treatment of Arthritis of the knee that we use are:
1. Unloading knee brace – for cases of Bowed knee with cartilage wear
2. Muscular training – to increase strength and flexibility in the muscles around the knee
3. Knee injections – to reduce swelling, reduce pain and to maintain the knee joint.
Our Approach to knee injections:
Our approach to knee injections is that the AIM for knee injections is
1. to reduce pain and swelling
2. Maintain joint viscosity
There are 2 main types of knee injections:
a. INTRA ARTICULAR (inside the knee joint)
b. EXTRA ARTICULAR (around the knee joint)
We diagnose clinically the exact region and area / tissue of pain in the knee before considering the type of injection to be given.
1. Intra articular knee swellings require – intra knee joint aspiration of fluid and injection of either Hyaluronic acid gel or steroid injection
2. Pain localised to the peri- articular tendons and bursa as well as muscles – Extra articular injection of anaesthetic and mild anti-inflammatory injection to REDUCE inflammation and swelling in the bursa and tendons which are inflamed. These injections have nothing to do with intra-articular knee injections.
We have many different brands of Intra-articular gel injections but the most common that we use is Go-On HA injection. It is a maintenance gel injection to reduce and smoothen the joint fluid. It is helpful to get 1 injection every 3 months for joint maintenance.
The most important take home message for patients:
1. Do not be afraid of using knee injections to help reduce knee pains
2. See a doctor who is knowledgeable on the various forms of knee injections as different types of knee pains require different injections.
3. Do not forget the first 2 pillars of arthritis treatment which are Bracing ( when required) and muscular training for the thigh and hip muscles.