Dr. Kenton Fibel weighs in on the efficacy of injectable treatments to combat knee osteoarthritis.
Article Link: Do Knee Injections for Pain Actually Work? (aarp.org)
About 1 in 7 people diagnosed with knee osteoarthritis will receive some sort of injection to treat the painful, sometimes debilitating, symptoms of the disease. Yet studies in recent years have found that most of these injections actually do very little to improve osteoarthritis in the knees and are only slightly more effective than a placebo.
In its 2021 guidelines, the American Association of Orthopaedic Surgeons (AAOS) “conditionally recommended” the use of one type of injection — corticosteroids — and advised against HA injections. Two other types — PRP and stem cell injections — are not fully approved by the Food and Drug Administration and are regarded as experimental by insurance companies. To help you wade (knee-deep) through the confusing world of injections, here’s a rundown of the most common kinds of shots and what the experts say about them.
Platelet-rich-plasma. What is it? PRP injections are developed by extracting blood from a person, then separating out the plasma, which is rich in platelets, from other parts through centrifugation. The concentration of platelets in the new mixture can be 5 to 10 times richer than in normal blood. Researchers say the shots promote healing and lessen inflammation, which should reduce pain and swelling.
Does it work? Research is ongoing, but several studies have found PRP to pack a powerful healing punch more effective than HA injections.
“There is good evidence for the use of PRP,” says Kenton Fibel, M.D., a nonoperative orthopedic sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles and medical director for the Anaheim Ducks. “The injections last about a year, and pain and function improve.”
What to know: The Arthritis Foundation recommends that PRP injections be done by a specialist, either an orthopedic surgeon or a sports medicine doctor. Ultrasound imaging is often used to help target the precise point in the joint space to insert the needle for maximum effectiveness. The procedure can be performed as a onetime injection or every week for three weeks. Because it’s not fully approved by the FDA, it’s generally not covered by insurance; a series of injections can cost around $2,000.
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