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 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.
In general, 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 and HYALGAN HA injection. Both are maintenance gel injection to increase 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.