Osteoarthritis is a degenerative disease of the articular cartilage accompanied by an inflammatory component. The process involves degradation of the articular cartilage, but also synovial, remodeling of the subchondral bone, degeneration of the ligaments, and other intraarticular structures (such as knee meniscus) and articular hypertrophy. The main symptom of osteoarthritis is pain, followed by decreased joint mobility which significantly affects the quality of life.
In the treatment of osteoarthritis, or its underlying symptom, in addition to medication therapy and physical-rehabilitation procedures, intra-articular injections are important.
There are several types of intra-articular injections and the orthopedic specialist will determine which injection is appropriate for treatment depending on the progression of osteoarthritis, the age of the patient, body building, activity, lifestyle and eventual comorbidities.
Types of intra-articular injections
1. Corticosteroid injections – used for short term pain relief in the joint (2-3 months) and reduce the inflammatory process of the joint. Due to possible side effects it is not recommended to use them more than twice a year in the same joint.
2. Hyaluronic acid preparations (viscosity supplements) – used when calming active inflammation in the joint (are also a better choice than corticosteroids in patients with diabetes because corticosteroids raise blood sugar levels). Hyaluronan preparations help the joint fluid to regain its normal properties and act as lubricants and shock absorbers, i.e. as a barrier to inflammatory cells in the joint, and can even stimulate the joint to begin to heal more naturally. One treatment soothes the symptoms for half a year to a year, and sometimes longer. Commonly used in the treatment of knee joints, it is recommended to give them once to twice a year.
3. PRP – platelet rich plasma – is made from the patient’s own blood, which is appropriately taken from a vein, centrifuged, and prepared by injection. Its action is to utilize the growth factors found in platelets that act on the immune response and reduce inflammation in the joint. The advantage of this method is that it is biologic and autologous and can be safely repeated many times.
Intra-articular injections are administered in sterile conditions – sterile gloves and sterile cleaning and insulation of the treated joint. After the application, the patient is advised to apply cold compresses on the wrist and to reduce physical activity in the same day. If needed, injections can be ultrasound or X-ray controlled.