Arthritis of knee is a problem which can be managed in many ways. They is modification of life style, physiotherapy and medication which include analgesics and anti inflammatory medicines. Ligament reconstruction and knee replacements are the other exiting systems for managing knee arthritis. Another treatment option introduced during 1950s is intra-articular injection of corticosteroid or hyaluronic acids. Though initially this method was considered to be a clear cure for arthritis, experience during the past 60 years have proved that it is not so. This procedure is not preferred by many surgeons and patients as the continuous usage of intra articular injection has been found to have many side effects and demerits.
Corticosteroid is a steroid which has anti-inflammatory properties. This injection reduces number of lymphocytes and inflammatory mediators like leukotrienes. This injection protects bone cartilage from destruction by reducing metalloproteinase synthesis. Hyaluronan is injected into the joint to reduce pain and improve its motion range. In cartilage damage, synovial fluid losses its ability to lubricate and the cartilage is destroyed. Hyaluronate acts as a lubricant and makes the bones move without much pain and hindrance.
Benefits and risks:
One of the adverse effects of intra-articular injections is that they can cause infections and can lead to local reactions. It has also been found that the use of intra articular injections is causing increase of blood sugar level in diabetic patients.
Another problem with this injection is that repeated frequent use may worsen destruction of joints. At least 4 to 6 weeks time lag is required between successive injections of intra-articular injections.
Preparation method of steroids for intra-articular injections is different form one doctor to another. Hence the period for which these injections have to be taken and how long the medicine will be affective will also vary.
Hyaluronan injections are also given to buy time for the knee replacement surgery. Relief for a period up to one year can be seen by undergoing treatment for 4 to 6 weeks.