Knee injections and osteoarthritis - PRP, Hyaluronic acid (Euflexxa, Synvisc), Steroid

Mild-moderate knee arthritis and pain troubling you?

First-line treatment should be: physiotherapy, weight-optimisation, stay active & non-steroidal anti-inflammatory medication.

If your knee is still troubling you despite your initial efforts, then an intra-articular knee injection may be right for you.

Platelet-rich plasma (PRP): Growing evidence shows some benefits (improved pain and function) of PRP injections over other injections (steroid, hyaluronic acid and normal saline). The theory is the growth factors help decrease the inflammation in the knee and in theory promote restoration of damaged cartilage (not proven). It is best used in mild-moderate arthritis. It can’t ‘reverse’ severe (bone on bone) arthritis.
Dr Collins does not perform PRP injections in his rooms, he does perform them in theatre during other associated procedures.

Hyaluronic Acid (synvisc, synvisc-one, durolane, euflexxa): Viscosupplementation involves injecting a ‘lubricant’ (synthetic hyaluronic acid, similar to normal joint/synovial fluid) into the knee. It has similar results to PRP with some studies favouring PRP and some studies showing no difference either way.
Dr Collins does not perform these injections himself as he does not stock the injections, if you’re able to obtain/source the synvisc/durolane or otherwise from a chemist (Dr Collins can provide prescription), he is able to inject it for you during a consultation appointment.

Steroid: A corticosteroid injection decreases the inflammation and subsequently the associated pain of arthritis. During a ‘pain’ flare or attack it is good short-term solution for knee arthritis that is heading towards a knee replacement
Dr Collins can perform a steroid injection to your knee if indicated during a consultation appointment.

RF Ablation of the knee genicular nerves is another non-operative option for knee arthritis pain. Dr Collins utilises the coolief system for both hip and knee arthritis pain relief for appropriate patients. Further information is available here: https://www.mycoolief.com/about/

There is no perfect/right injection, and the evidence for all the above treatments is growing but still debated/controversial. The main risk/down-side for injections is the risk of infection and/or the injection not helping/working, as well as the associated costs.

It’s best to discuss the options with your treating healthcare professionals to make an informed decision/choice.

If the above multi-modal approach isn’t helping, contact us to make an appointment with Dr Collins to discuss further options, including surgical intervention (joint preservation and/or joint replacement).