Are Knee Lubrication Injections Worth It?
At SSOR, we have a fairly results-oriented, high-demand patient population that comes through our doors. Knee arthritis is a common condition as people age and it tends to be accelerated in people who either had surgery or who were avid athletes “back in the day.” Some patients though are in a difficult position – they have a fair amount of pain and dysfunction, but they aren’t quite old enough yet for a total knee replacement. Total joint replacements last anywhere from 10-20 years right now, but this depends on a number of factors. Therefore, many surgeons hesitate to do a total knee replacement on younger patients. So what options are out there?
Knee Arthritis and Knee Lubricating Injections
The American Medical Society for Sports Medicine recently released a position statement on “viscosupplementation” for knee arthritis. Viscosupplementation is just a fancy term for knee lubrication injections for the knee. Basically, as a knee deteriorates from arthritis, it loses its natural lubrication from the synovial fluid in the joint. Effectively, the knee “dries out.” Pain and dysfunction result. Just like a squeaky wheel, your knee needs “grease” to be most healthy and without pain. The knee lubrication injections basically help to provide lubrication to the knee. Normally, you get three injections spread out over time. These injections basically are just buying you time.
What’s the difference between cortizone injections and knee lubricating injections?
We get asked this a lot. Of course, we encourage you to talk to your doctor about what option is best for you. Cortizone injections are basically a powerful steroid that serves to decrease pain and inflammation in the joint. Again, you typically get up to three spread out over time. Research has shown that they do help in the short-term, but long-term, they have a negative effect on the joint. It’s the ultimate “catch-22.” We usually suggest to our patients that the cortizone shots are a great idea if say, you want to enjoy that beach vacation without hobbling around or being a “party pooper” because your knee hurts too much. Maybe you have a child getting married in a couple of weeks and you don’t want to limp down the aisle. In these cases, we say go for the cortizone. It is not a long-term fix though. Much like the lubricating injections, they are only delaying what is likely inevitable – a total knee replacement. We suggest doing the knee lubrication injections and let them last as long as possible, then look to the cortizone down the road. Ideally, you have as little of the cortizone shots as possible.
Can physical therapy help?
Physical therapy can help – to an extent. We can’t change the knee arthritis, but we can help with impairments related to it. For example, if you are stiff in the joint or have tender muscles surrounding the knee, we can do soft tissue work and manual therapy to the joint to help maximize what available motion you can have. We will also give you exercises to not only strengthen the knee but also the hip muscles. The hip muscles are critical because they support the knee. We’ll give you stretches when appropriate and even talk about things for pain management. You would be surprised all the “little things” you can do to take the edge off of your pain. Stationary cycling and pool exercise is a great way to stay active and really helps reduce pain and keep what motion you do have. Of course, weight management helps too. The more weight you take off, the less stress on your knee. Ultimately, after taking care of all of these things, committing to a long-term home program is what you need.
It would be a privilege to serve you and partner with you in your care. We have locations in Overland Park and Prairie Village for physical therapy to help you. Give us a call!