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Injections for knees

Updated on August 26, 2012

Degenerative Knee Joint

Diagram of a knee joint that is worn out.
Diagram of a knee joint that is worn out.

Knee Joint Injection: Different types

A knee joint injection can be given for many different reasons. A knee joint injection can be given due to prolonged inflammation of the joint. This can mean injury that's temporary, such as a sports injury. These injections are also given as pain relief in knees that are considered degenerative(over used, often injured). A knee joint injection is often given by an orthopedic doctor, or pain specialist. It is a procedure that can be done in a clinic setting and you can go home the same day. Many people that get knee joint injections notice a considerable difference after the injection is given. Such as an increase in the motion of the joint and amount of weight that the joint can hold. Of course, the main difference that people notice is a decrease in pain. There are a few different kinds of knee joint injections that I will go over. All of which can be given by an orthopedic doctor. Schedule an appointment with your local orthopedic doctor to see if a knee joint injection is right for you.

A Knee Joint injection is given for Pain relief and sometimes Knee Joint Preservation!

The first knee joint injection I would like to talk about is the use of steroid injection. This would involve the use of Depo-Medrol 40mg or Celestone Soluspan 6mg(betamethasone) mixed in a syringe with 1% lidocaine to help numb the knee joint. This injection can be done in the clinic, it involves sitting on the edge of the patient table with your knees dangling. The knee is then cleansed with either Betadine or chloraprep. The physician then feels for the knee joint just below the kneecap. Sometimes for comfort, just before the injection is given the skin can be sprayed with Ethel chloride. Ethel chloride numbs the skin so that the needle is not felt going through the skin. Basically, Ethel chloride makes the skin 'freezing cold'. The physician, once inside the knee joint will pull back on the syringe(aspirate) to ensure that they are not in the bloodstream. If there's no blood return they will then inject into the joint and several different locations. Each time the physician changes the location of the needle in the knee joint, they make sure they are not in the bloodstream by pulling back on the syringe(aspirate).

Knee Joint Injection

Knee joint injection is given just below the kneecap or patella by a physician
Knee joint injection is given just below the kneecap or patella by a physician

Knee joint Injection

Knee Joint Injection with Regular synvisc

Regular Synvisc that consists of three shots over three weeks.  "Rooster Combs"
Regular Synvisc that consists of three shots over three weeks. "Rooster Combs"

Knee Joint Injection

Celestone Soluspan (betamethasone) Injection with lidocaine 1% (not pictured)
Celestone Soluspan (betamethasone) Injection with lidocaine 1% (not pictured)

Rooster Comb Injection: Synvisc or Synvisc-One

Another type of injection is known as the rooster comb injection. This is another injection of the knee joint. The medication is known synvisc . Regular Synvisc consists of three shots on three different office visits, one week apart. Synvisc One is another version of the rooster comb injection with the exception of it being one shot, one visit. This is because Synvisc One is three shots rolled into one. The main reason regular Synvisc is chosen over Synvisc One is the price. Synvisc One is about $1200 as opposed to regular Synvisc, which is about half the cost. The procedure for injecting a Synvisc shot varies on the physician but it is always done using sterile technique. The same as doing a knee joint injection with steroids. The only difference is the physician just needs to attach the needle to the Synvisc syringe. The area just below the kneecap is cleaned with either Betadine or ChloraPrep, and once again when the needle has entered the joint the physician will aspirate to ensure there is no blood return and then inject into the knee joint.

Ultrasound guided knee joint injections, plain xrays are used as well!

Another type of knee joint injection is the ultrasound guided injection. This type of knee joint injection is normally done because a specific area has been identified on either an MRI, CT, or plain x-ray that the physician wants to visualize with ultrasound in order to ensure proper placement of either Synvisc or steroid. This type of knee joint injection is also done in about 30 min. and you can go home the same day. An ultrasound guided knee joint injection is prepped the same as the other injections spoken about above. Obviously, the only difference is the presence of ultrasound tech and use of ultrasound wand during injection. It is important to note the ultrasound does not have any x-ray hazards.

Temporary relief at varying degrees depending on the person: Knee joint Injections are not normally a permanent fix

It is important to know when getting knee joint injections that they are given for pain relief and temporary maintenance of degenerative joint disease. Mainly to delay the need for total knee replacement. Unless of course you have an acute injury such as sports injury. If your knees are in bad shape due to overuse then these need to injections are used as a conservative type of treatment. This type of conservative treatment is normally used hand-in-hand with some type of physical therapy program. For those with the degenerative knee joints these injections can help get a few more good years out of their knees before replacement is needed. Normally when you're ready to get a new replacement you will practically be trying the surgeon to the OR with you to get your knee joint replaced. The steroid injections are given for pain relief and it is important to notify the physician that injected your knee joint as soon as the pain comes back. This would give the physician an idea of how bad the knee joint is and if it is time to go-ahead with surgery or not. Get employment with your local orthopedic surgeon or have your primary physician refer you to an orthopedic doctor to see if your candidate for these types of injections into the knee joint.


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      9 years ago

      Very interesting look at this procedure of a knee joint injection.

      There is a history of arthritis in my family and already, in my middle age, I am beginning to feel the heat and slight pain in various joints that is probably an indicator of the slow onset of this condition.

      It is of some comfort to realize that there may, further along the line, be treatments such as this to provide pain relief.


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