HA injection
Hyaluronic acid injections may reduce osteoarthritic symptoms by one or more of its following properties:
- Lubrication. In some people, the viscosity of hyaluronic acid may provide better lubrication and shock absorption in the joint. These effects may reduce friction within the joint, thereby reducing pain and stiffness, and preventing the loss of cartilage and bone.
- Anti-inflammatory effects. Research shows hyaluronic acid injections may provide anti-inflammatory effects such as reduced pain, inflammation, and/or swelling in the joint.
- Pain-relieving effects. In some people, hyaluronic acid molecules form a boundary around nerve endings, preventing pain signals from being sent to the brain. These molecules also bind to other cells in the joint that signal pain.
The procedure for hyaluronic acid knee injections involves the following steps:
- The patient either lies on his or her back with the knee straight or sits upright with the knee bent—this position would depend on the doctor’s preferred approach to insert the needle into the knee capsule.
- The knee is wiped down with a disinfectant, such as alcohol or iodine.
- The patient is asked to relax the leg muscles; this will facilitate a successful injection and may also make the injection less painful.
- If the knee is swollen with excess fluid, the doctor may aspirate (draw out) this fluid with a needle and syringe.
- This injection is only effective if the hyaluronic acid is delivered directly into the knee joint (not the surrounding tissues).
- The injection area will be cleaned and bandaged.
- The patient will be told to straighten and bend the knee several times to help spread the material throughout the knee joint.
- This injection technique requires the expertise of a trained medical professional who can deliver the hyaluronic acid into the joint capsule of the knee
A period of 12 to 24 hours of rest immediately after the injection. Resting after the injection helps to reduce injection pain and also decreases the chance of hyaluronic acid being flushed away from the joint capsule.
Patients may perform simple, low-impact activities during this rest period, like slow, short walks.
Physical therapy
A follow-up program including physical therapy and at-home knee exercises. These practices help build and maintain muscle strength around the knee joint.
Supplements
In addition to physical therapy, oral supplements, such as symptomatic slow acting drugs for osteoarthitis (SYSADOA), curcumin, may be recommended. There is some evidence that taking supplements may improve the outcome of hyaluronic acid injection treatment for osteoarthritis.
PRP injection
Platelet Rich Plasma (PRP) is a concentration of one type of cell, known as platelets, which circulate through the blood and are critical for blood clotting. Platelets and the liquid plasma portion of the blood contain many essential factors for the cell recruitment, multiplication, and specialization required for healing.
After a blood sample is obtained from the patient, it is put into a centrifuge to separate the blood into its many components. Platelet-rich plasma can then be collected and treated before delivering it to an injured area of bone or soft tissue, such as a tendon or ligament.
PRP is given to patients through an injection. After the injection, a patient must avoid exercise for a short period before beginning a rehabilitation exercise program.
Arthroplasty surgery
Arthroplasty is a surgical procedure performed by an orthopedic surgeon that alters or completely replaces a joint in the body, usually to restore normal motion and relieve pain in a joint, such as the hip, knee, shoulder, elbow, or ankle.
A patient may require arthroplasty surgery due to cartilage that wears out, limb/joint malalignment, joint space narrowing, a stiff joint, disease, or other degenerative or traumatic conditions.
During joint arthroplasty, the orthopedic surgeon uses special instruments to remove damaged portions of the joint and replace them with artificial components. Stems or pegs on the synthetic joint components are fitted into the healthy, remaining part of the bone and kept in place with either bone cement or a special coating on the implant that fosters new bone growth in the area. The fixation method used is based on the patient’s age, bone quality, and activity level.
Following arthroplasty surgery, patients should expect to undergo a rest and rehabilitation period. They will gradually regain strength and flexibility in the area surrounding the replaced joint and re-learn how to use it.
