Knee Arthritis: Cortisone & Gel Shots
When it comes to knee arthritis, there are different ways to tackle the problem. As medicine has evolved, new techniques and procedures have been created and implemented to improve patients with arthritis. Among them, the relative new stem cell treatment. However, traditional methods like cortisone and gel injections shots have been around for a while and offer some benefits as well. If you are suffering from arthritis, getting to know the whole spectrum of your options will give you a better overview of your possibilities in order to set realistic expectations. The following is a quick informative introduction of cortisone shots and gel injections as used to help relieve arthritis. Take a look and draw your own conclusions.
Cortisone shots can provide reasonable short term relief for an inflamed knee and are typically the first option people with osteoarthritis choose. These are used by orthopedic doctors mainly as a rescue shot. Many people with osteoarthritis will be functional the vast majority of the time, but will have occasional pain episodes 1-2 times a year. This can help rapidly calm the knee down. The first shot infrequently will last several months, but repeated injections will only help for a few weeks (3-6). They can be repeated every 3-4 months as needed. Cortisone shots are not a good long term strategy because it ceases to be effective. Cortisone is also detrimental to joint health and has been shown to be toxic to the living cell in the joint cartilage.
Gel Shots for Arthritis
Gel injections are composed of hyaluronic acid. The same compound that is present in the joint fluid also known as synovial fluid. The theory behind this injections is that in arthritic knees the molecular weight of the hyaluronic acid decreases. By adding a larger molecule, the shock absorbing capability increases. This is like adding a thicker motor oil to a car’s engine where the motor oil is thin. It is not clear how this shots help because they have been shown in radioactive labeling studies to be no longer in the knee 48 hours after the injection. This shots are intended for and work best in knees that have at least 50% of the joint space remaining. They work least well when bone on bone contact is present. Typically this injection are given in a series of one a week for three weeks. The series can then be repeated every six months as needed.
Numerous studies have shown that the gel injections are no more helpful than cortisone injections. However, they do not harm the articular surface like cortisone. Unlike cortisone, 10%-20% of the patient may develop an adverse reaction to the shots and experience severe pain and swelling within 72 hours of injection. A cortisone shot can be used as a rescue shot in this circumstances. When this happens, patients may be suspended from the injections. Shots are expensive and Blue Cross will no longer reimburse them. Medicare requires at least 3 months of prior treatment before the authorize this injections.
Orthopedic Corner | Leon Mead MD Orthopedic Doctor | 730 Goodlette Road North, Suite 201 Naples Florida 34102 | Phone: (239) 262-1119