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Knee Injections and Viscosupplementation
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Introduction
Knee injections and viscosupplementation are at the forefront of non-surgical treatments for knee pain, particularly in cases of osteoarthritis. These procedures aim to alleviate pain, enhance joint mobility, and offer a potential delay in the progression towards surgical intervention.
By providing targeted relief directly within the affected joint, these treatments also aim to improve the patient’s overall quality of life, allowing for increased activity levels and a reduction in the use of oral pain medications.
What is Viscosupplementation?
Viscosupplementation involves injecting hyaluronic acid into the knee joint to alleviate pain and improve mobility in patients with osteoarthritis. Hyaluronic acid, a substance naturally present in synovial fluid, acts as a lubricant and shock absorber, facilitating smoother joint movements.
This treatment is especially suited for those who haven’t found relief through conventional methods such as medications or physical therapy. By restoring the synovial fluid’s natural properties, viscosupplementation can provide significant pain relief and improved joint function. It represents a key non-surgical option in the management of knee osteoarthritis symptoms.
Other Types of Knee Injections
Other than viscosupplementation, various types of knee injections offer alternative approaches to managing knee pain and promoting tissue healing.
- Corticosteroid Injections
Corticosteroid injections offer quick relief by reducing inflammation and pain in the knee joint. Often used for acute flare-ups, these injections can provide significant relief but are generally considered a short-term solution. - Platelet-Rich Plasma (PRP) Injections
PRP injections use a concentration of the patient’s platelets to promote the healing of injured joints, tendons, ligaments, and muscles. By stimulating the body’s natural healing processes, PRP can improve joint function and reduce pain without the use of drugs or surgery. - Stem Cell Injections
Stem cell injections aim to repair and regenerate damaged knee tissue. This innovative approach uses stem cells derived from the patient’s body to encourage the healing of joint damage, offering a potential for long-lasting relief and recovery.
The Procedure: What You Can Expect
Before the Procedure
Before receiving a knee injection, patients undergo a thorough evaluation, including a medical history review, physical examination, and possibly imaging tests, to determine the most appropriate type of injection. Patients are advised to discuss any medications or supplements they are taking, as some may need to be paused before the procedure.
During the Procedure
Knee injection procedures are typically quick and performed on an outpatient basis. The skin around the knee is cleaned, and a local anaesthetic may be applied to minimize discomfort. Using sterile techniques, the chosen substance is injected directly into the knee joint. The procedure usually lasts just a few minutes, and patients often feel minimal discomfort due to the local anaesthetic.
After the Procedure
Immediately following the injection, patients might experience mild soreness or swelling at the injection site, which usually subsides within a few days. Most individuals can resume their normal activities shortly after the procedure, although strenuous activities should be avoided for a specified period as advised by the physician. Patients are often encouraged to engage in a gentle range-of-motion exercise to aid in recovery.
Benefits of Viscosupplementation and Knee Injections
Knee Injections encompass a wide variety of benefits that include:
Pain Relief
These treatments can significantly reduce knee pain, allowing patients to engage in daily activities with greater ease and comfort.
Improved Mobility
By addressing the underlying issues in the knee joint, such as inflammation or lack of lubrication, patients often experience improved joint movement and flexibility.
Delayed Surgery
For some individuals, knee injections can postpone or even eliminate the need for knee replacement surgery by managing symptoms effectively.
Minimal Downtime
As minimally invasive procedures, knee injections usually require little to no downtime, enabling patients to quickly return to their normal activities.
Low Risk of Complications
Compared to surgical options, knee injections carry a lower risk of complications and side effects, making them a safer choice for many patients.
Potential Risks and Side Effects
While knee injections and viscosupplementation are generally safe and effective, as with any medical procedure, they carry potential risks and side effects. These may include:
- Injection Site Reactions: Patients may experience pain, swelling, or redness at the injection site, although these symptoms typically resolve quickly.
- Infection: Although rare, there is a risk of infection at the injection site, requiring prompt medical attention.
- Allergic Reactions: Some individuals may have an allergic reaction to the substances used in the injections, particularly in the case of hyaluronic acid or corticosteroids.
- Temporary Increase in Pain: Patients may experience a temporary increase in knee pain following the injection, usually subsiding within a few days.
- No Relief from Symptoms: Patients may not experience significant relief from their knee pain after the injection, necessitating further evaluation and treatment options.
Who is a Good Candidate for Viscosupplementation?
Ideal candidates for viscosupplementation typically include individuals experiencing knee pain due to osteoarthritis, particularly those who:
- Have mild to moderate osteoarthritis.
- Have not found sufficient relief from oral pain medications, physical therapy, or lifestyle changes such as weight loss and exercise.
- Are seeking an alternative to corticosteroid injections due to side effects or contraindications.
- Wish to delay or avoid knee replacement surgery.
Patients with severe osteoarthritis or significant knee joint damage may not be suitable candidates, as viscosupplementation is less likely to be effective in the advanced stages of the disease. A thorough evaluation, including a review of medical history, physical examination, and possibly imaging studies, is necessary to determine whether viscosupplementation is an appropriate treatment option.
Recovery and Rehabilitation
Recovery and rehabilitation from knee injections aim to enhance joint function and mobility with minimal interruption to daily activities.
- Rest
Patients are advised to rest the treated knee for at least 24 to 48 hours post-procedure, avoiding strenuous activities to minimize swelling and discomfort. - Ice
Applying ice to the knee can help reduce swelling and pain. It’s recommended to ice the knee for 15-20 minutes several times a day for the first few days after the injection. - Exercise and Physical Therapy
Gentle range-of-motion exercises may be recommended to help maintain knee mobility and strength. A physical therapist can provide a personalized exercise plan tailored to the patient’s condition and recovery goals. - Pain Management
Over-the-counter pain relievers may be used to manage discomfort, but it’s important to consult before taking any medication post-procedure.
Patient Feedback
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
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Frequently Asked Questions (FAQs)
How long does it take for the injections to work?
The onset of relief from knee injections can vary depending on the type of injection and the individual’s condition. Corticosteroid injections may provide relief within a few days, while hyaluronic acid and PRP injections may take several weeks to show full effects.
How often can I receive knee injections?
The frequency of knee injections depends on the specific type of injection and the patient’s response to treatment. Generally, corticosteroid injections are limited to a few times a year to avoid potential side effects, while hyaluronic acid injections may be repeated every 6 months or as recommended.
Can I undergo knee injections if I have had knee surgery in the past?
Many patients who have had knee surgery can still benefit from knee injections, but it depends on the type of surgery and the current condition of the knee. A thorough evaluation is necessary to determine suitability for injections post-surgery.
Can knee injections affect my ability to travel?
Knee injections typically do not directly restrict your ability to travel. However, it’s advisable to avoid long periods of immobility, such as sitting on a flight or car ride, immediately after the procedure to reduce the risk of swelling or discomfort. Plan to move or stretch your legs periodically during travel to maintain circulation and joint movement.