Steroid Injection
Braces & Wedges Microfractures
What is it and why?
-
The injection of corticosteroid medication and local anaesthetic into the joint.
-
This should decrease inflammation from the degenerating joint, which is causing pain and swelling.
-
This will be appropriate for selected patients who have tried other methods.
- Applicable stages 4 & 5
- Best stages 4 & 5
- Cost Very low cost
-
Home/self-help
-
Hospital
-
Daycase procedure
-
Inpatient procedure
-
Local anaesthetic
-
General anaesthetic
-
Regional block / Spina
-
Pain
May worsen
-
Mobility
Minor
-
Daily activities
Minor
-
Driving
Minor
-
Leisure activities
Minor
-
Light exercise
Minor
-
Heavy exercise
Minor
-
Light work
Minor
-
Heavy work
Minor
-
Intimate
Minor
Overview
What does it involve?
-
This is a minor procedure carried out in the outpatient department by a trained clinician.
-
The affected knee joint is cleaned with aseptic precaution.
-
Following this, a combination of local anaesthetic and corticosteroid will be injected directly into the joint.
Effort/burden
-
There will be no additional effort required from the patient.
-
This is usually a one-off procedure to address the pain. However, it may need to be repeated.
Benefits
-
There is fair to good evidence for using intra-articular steroid injection. About two-thirds of patients benefit from this injection.
-
However, it is difficult to predict who will benefit most or how long the effects will last.
-
Moderate drop in pain, improvement in activities of daily living (ADL) and mobility in the short term.
Chances of cure
-
These measures are unlikely to cure arthritis on their own.
-
However, they can improve the symptoms of arthritis, activities of daily living and mobility.
Limitations and side effects
-
In the initial stages, some report exacerbation of pain, though this is usually short-lived.
-
Increase activity gradually a few days after receiving the injection.
-
Minor side effects include a change in local skin colour and fat atrophy.
-
The injection should be used with caution for patients with bipolar disorders, active infection, pregnancy/breastfeeding or recent vaccination.
-
Avoid this intervention if you have an allergy to the medication or to the local anaesthetics.
Risks
-
No major risks associated with the use of cortisone injection.
-
There is a minimal (0.5%) risk of introduction of infection.
-
Repeated injections can weaken the ligaments and may worsen the arthritis.
Cost
-
This is a no cost option for the patient, and has a variable cost for the NHS.
-
NHS: Generally not an expensive option; the cost of treatment of infection, should it occur, could be expensive.
What if no treatment is done?
-
Arthritis will continue to deteriorate.
-
Symptoms will get worse; sometimes rapidly.
-
Will have a negative influence on other management options, e.g. surgery, in the future.