Knee Shots for Arthritis: Exploring Your Options In London

Arthritis occurs when the cartilage in a joint wears away, exposing the bones. This bone exposure leads to pain, swelling, and reduced function. Generally, simple treatments such as exercise, medications, and weight loss have the best effect on arthritis. However, we use knee injections for arthritis in London to help these simple treatments in complex cases. So, what are the options for knee shots for arthritis, and how do you decide which one to choose?   

Knee Shots for Arthritis: What is available?

We can use cortisone, hyaluronic acid, or platelet-rich plasma.

Cortisone injections for arthritis 

Cortisone is the most commonly used injection. It is a potent anti-inflammatory drug that reduces inflammation, swelling, and pain.

Overall, studies show short-term improvement in knee pain after a cortisone injection. Generally, the cortisone effect is better in milder cases of knee arthritis and lasts up to 3 months. However, there is no difference between cortisone injections and placebo at six months for knee arthritis.

Moreover, there are some concerns about cortisone injections for knee arthritis. For example, a recent study shows you are twice as likely to have cartilage damage after a cortisone injection compared to other injections. In addition, there is worrying evidence that having a cortisone injection could increase your risk of needing a joint replacement earlier. If you plan on having a knee replacement, studies suggest avoiding having a cortisone injeciton for up to 3 months before surgery. 

Gel injections for arthritis 

We also use hyaluronic acid (Ostenil, Durolane, Synvisc) to treat osteoarthritis.

Hyaluronic acid is a natural substance found in bones, joints, and tendons. Injecting hyaluronic acid into a knee joint lubricates and reduces inflammation.

Overall, studies show a moderate effect on pain from osteoarthritis that can last for 6-12 months. However, a high-molecular-weight, cross-linked hyaluronic acid is more effective for knee arthritis. A recent study found that a high-molecular-weight cross-linked hyaluronic acid has a more significant pain-relieving effect than most other injections or medications. Specific high-molecular-weight brands include Durolane and Synvisc-1. In addition, there are a few side effects beyond occasional reactions. All in all, hyaluronic acid is a good option for mild to moderate knee arthritis.   

PRP injection for arthritis 

Platelet-rich plasma (PRP) is becoming more popular for treating arthritis and tendonitis.   

We obtain PRP from whole blood. Then, we spin the blood to separate the plasma from red and white cells. Plasma contains a high concentration of platelets that are rich in growth factors. Finally, the plasma is injected into joints. 

Overall, 23 studies show a positive effect of PRP on knee osteoarthritis. Furthermore, comparing PRP to other injections, such as hyaluronic acid, shows a slightly better effect of PRP, though more than one injection is required. 

Generally, we recommend three injections of standard PRP for knee arthritis. However, a novel second-generation PRP system, Arthrex ACP Max, is now available, providing a higher platelet dose and concentration, allowing only one shot. 

Arthrosamid injeciton for knee arthritis

Arthrosamid is a unique hydrogel of water molecules attached to a polyacrylamide backbone. The injectable is non-degradable, meaning the body does not break it down. 

It works by coating the synovial lining of the knee joint, reducing inflammation, and providing lubrication.

Recent studies show improvements in pain scores that last up to 5 years. Compared with hyaluronic acid, arthrosamid works better in younger, slimmer patients. Arthrosamid is an excellent option for patients with knee arthritis who have failed other injectables, such as hyaluronic acid or PRP. 

Comparing Injectables, Durolane, PRP or Arthrosamid: Which Knee Shot for Arthritis is More Effective?

According to studies published on each injectable for knee arthritis, we think the effectiveness for the treatment of knee arthritis in percentage terms is as follows: 

Durolane: 65-70%

PRP: 65-70%

Arthrosamid: 75-90% 

Stem cell injections for arthritis in knees 

Stem cell therapy is becoming more popular as an injection for arthritis. These stem cells can differentiate into other cell types and regenerate new tissue. 

Stem cells are usually derived from various sources, including fat, bone marrow, and fetal tissue. However, taking and processing these cells can be difficult and expensive. So, is the hassle and cost worth it?

Generally, the answer is no. While some smaller, lower-level studies show promise, higher-level studies show no difference between stem cells and sterile, cheap water. A recent study comparing stem cells to cortisone injections found no difference between groups at a year.

So, overall, we recommend that you don’t waste your money (up to £7000) on stem cells until further evidence of their effectiveness becomes available.

Other Frequently Asked Questions about Knee Shots for Arthritis: 

What is the best injection for knee arthritis? 

It depends on the patient. If you have severe acute pain and swelling, cortisone is a reasonable choice.

However, in longstanding low-level pain, other injectables with longer-lasting effects, such as hyaluronic acid, PRP or Arthrosamid, are available.

According to studies published on each injectable for knee arthritis, the effectiveness of  knee shots for arthritis in percentage terms is as follows:

Durolane injection: 65-70%

PRP injection: 65-70%

Arthrosamid injection: 75-90%. However, younger patients (less than 70 years) have 80-95% improvement. 

Arthrosamid is the most expensive of these injection options. 

Should you use ultrasound to guide knee injections? 

Yes. Ultrasound-guided knee injections are more accurate and practical than landmark-guided injections. A recent review found that ultrasound-guided injections were much more precise than blind injections. 

Final word from Sportdoctorlondon about Knee Injection for Arthritis in London

We use intra-articular injections for arthritis when other simple treatments like exercise and weight loss are not effective. Gene ally, use cortisone for a sore, swollen knee. Hyaluronic acid or Platelet-rich plasma is our preferred long-term choice. Finally, you should always perform injections with ultrasound to improve accuracy. If you’re thinking about an injection, you should do your homework and find a doctor with experience in ultrasound and injections.

Related conditions on Knee Injections for Arthritis in London:

• Durolane injections for arthritis
• Arthrex ACP Max: new one-shot PRP
• PRP recovery time: What to do before and after PRP
• Arthrosamid injection for knee arthritis
• Combined hyaluronic acid and PRP injection for knee arthritis
• Cortisone shot London: a new low-cost injection service. 
• Fees for ultrasound-guided injections for self-paying patients