Which type of injection is best for my arthritic knee?

Patients and even some non-patients often ask me: “What type of injection is best for my arthritic knee?”

There are several options available to the patient. They may receive a corticosteroid injection, platelet rich plasma (PRP), hyaluronic acid (HA) or stem cell injection. The dilemma is determining which one of those is the best for relieving symptoms from osteoarthritis.

A recent study from Rush Medical Center in Chicago may help answer this question. Cole et al (Am J Sports Med 2017, 45(2): 339-346) published a prospective study of 111 patients suffering from osteoarthritis of the knee joint. One group received PRP injection (leukocyte poor concentration) and the other received HA injections. The patients were evaluated at 6 and 12 months post-injection. The PRP group demonstrated a statistically significant improvement over the hyaluronic acid group at 24 and 52 weeks post-injections. (For a full description of the study and results, see the journal club section of this blog post.)

It is important to realize that the PRP injection is believed to have anti-inflammatory properties and is thought to be a beneficial component of a complete treatment plan that includes: exercise, active lifestyle, weight loss, physical therapy, and proper diet.

Immediately following a PRP injection, the patient should reduce activity level, use ice and perform light exercises for 1-2 weeks then gradually increase the exercise regimen and gradually resume functional activities. This has been shown to be beneficial in the majority of knee patients.

See Dr. Kevin Wilk’s preferred Glute Med exercises for Patella-Femoral and ACL patients and for stabilizing the hip and pelvis to reduce pressure into the knee in the video here and the photos below.

Gluteus Medius exercises 

Supine Bridge

Side-Lying Clam Shell

Side Bridge

Front Plank

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