Intra-articular Injections in Case Of Arthrosis of the Knee Joint

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Created: Saturday, 13 December 2014 12:30

Intra-articular injections are often used to provide emergency aid in case of arthrosis of the knee joint. In many cases, an intra-articular injection can indeed alleviate the condition of a patient. But at the same time the injections into the joint in case of arthrosis are made much more often than it is actually necessary. This is the trend, in our opinion wrong one, we want to talk about more. 

Most often medications of corticosteroid hormones are injected into the joint: kenalog, diprospan, hydrocortisone, flosteron, tseleston.

Corticosteroids are good because they suppress pain and inflammation in synovitis quickly and effectively (oedema and swelling of the joint). It is the rapidity with which the therapeutic effect is achieved is the reason why corticosteroid injections have gained particular popularity among the doctors. But this has led to the fact that intra-articular injections of hormones began to be applied even without a real need. For example cases are still frequent when hormones are injected into the joint of the patient with the prophylactic purpose to prevent further development of the arthrosis.

However, the problem is that the corticosteroids do not cure and cannot cure the arthrosis itself. This means that they cannot prevent development of the arthrosis as well! Corticosteroids do not improve the condition of the articular cartilage, do not strengthen the bone tissue and do not restore normal blood circulation. All they can is to reduce the response inflammatory reaction of the organism to one or another damage in the joint cavity. Therefore, application of the intra-articular injections of the hormonal preparations as an independent method of treatment is meaningless: they should only be used in a complex therapy of arthrosis. 

But even if the intra-articular injection of the corticosteroids is really necessary, a number of rules should be observed. Firstly, it is undesirable to make such injections into one and the same joint more frequently than once every two weeks. The point is that the administrated drug will not take an action in full force immediately and the doctor will be able to evaluate completely the effect of the procedure just after 10 to 14 days.  

One also should be aware that the first injection of the corticosteroids usually brings more relief than the subsequent ones. And if the first intra-articular injection of the drug has no effect, it is unlikely that the effect will come with the second or the third administration of the same drug in the same area. In case of ineffectiveness of the first intra-articular injection it is necessary either to change the drug, or to choose the injection area more precisely, if the change of the drug did not work. And if the injection of the corticosteroids into the joint has not given the desired result after this, it is better to abandon the idea of the joint treatment with the hormonal therapy. Especially since injection of the hormones into the same joint more than four to five times is extremely undesirable in general, otherwise it increases the likelihood of the side effects significantly.  

It is much more useful to inject the chondroprotectors (alflutop, arteparon) or special enzymes (contrycal) into the knee joint affected by the arthrosis. These drugs are applied in courses. From 3 to 15 injections of the enzymes or chondroprotectors are applied to one joint over the course of treatment. The advantage of these drugs is in their ability to influence the cause of the disease: they improve the condition of the cartilage tissue and normalize metabolism in the joint. That is, the chondroprotectors and the enzymes not only eliminate the symptoms of the disease but also cure the arthrosis, in contrast to the corticosteroids. A question arises: why intra-articular injections of the enzymes or chondroprotectors are less frequently used by the doctors? 

All the matter is that these drugs help only to 50-70% of the patients, and it is impossible to predict in advance will there be an effect or not. In addition, action of the drugs develops slowly unlike the hormones, and therefore, the enzymes and the chondroprotectors make minimal impression on the patient. This circumstance is of great importance due to the commercialization of medicine: nowadays the patients forced to pay for the medicine consider that money is well spent only when they get fast results. And not every patient will agree on a course of 5-10 intra-articular injections of the enzymes or chondroprotectors with no guarantee of recovery, considering their high cost.

Much safer, and which is the most important, faster in its action than the chondroprotectors and enzymes is a hyaluronic acid ("Austen", "Sinokrom", "Suplazin", "Dyuralan", "GO-ON'', "Rekosin'', etc.) appeared recently.  

The hyaluronic acid injected into a sore knee acts like a natural lubricant for the joint. It forms a protective film on the surface of the damaged cartilage which improves viscosupplementation, as well as protects the cartilage tissue from further damage. In addition, the hyaluronic acid penetrates deep into the cartilage, improving its elasticity and suppleness. Thanks to that the "dried up" and thinned with arthrosis cartilage regains its damping properties. Moreover it practically has no side effects if it is injected correctly into the joint cavity. 

Typically for treatment of gonarthrosis 3 to 5 injections of hyaluronic acid are applied into each affected joint. The injections are made with an interval of 7 to 10 days. Such a course is held once a year: in gonarthrosis stage I during two years; in arthrosis stage II – during 2-3 years; in arthrosis stage III - during 3-4 years. And although hyaluronic acid medications are still relatively expensive, their application allowed in a literal sense to “put on the feet” many patients from those who earlier, before the advent of this drug, clearly would have to be operated. What is especially true given the cost of the operations on the knee joints: application of the preparations based on the hyaluronic acid, even during several years in any case and in all senses costs the patients cheaper than the knee joint arthroplasty. 

You can always find the most complete range of products on the basis of the hyaluronic acid for treatment of the arthrosis at our online store, and it is also possible to order home delivery to any convenient place of the world. We are also happy to answer any additional questions which you can send to us via the form available in "Contacts" at our website.

We hope sincerely that this material will be useful for you and will help you when deciding on the most proper method of treatment and therapy of the arthrosis.  

** This material is prepared by the staff of the online store "Pegasus-Pharma" based on analysis of the specialized medical researches carried out in EU and the USA over the past 10 years, as well as the accumulated statistical information in the health care institutions of different countries. All rights reserved. When reprinting the reference to our website is obligatory.