Steroid Injection

Braces & Wedges Microfractures


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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.


  • Treatment does not involve Home/self-help
    Home/self-help
  • Treatment involves Hospital
    Hospital
  • Treatment involves Daycase procedure
    Daycase procedure
  • Treatment does not involve Inpatient procedure
    Inpatient procedure
  • Treatment involves Local anaesthetic
    Local anaesthetic
  • Treatment does not involve General anaesthetic
    General anaesthetic
  • Treatment does not involve Regional block / Spina
    Regional block / Spina
  • Pain
    Pain

    May worsen

  • Mobility
    Mobility

    Minor

  • Daily activities
    Daily activities

    Minor

  • Driving
    Driving

    Minor

  • Leisure activities
    Leisure activities

    Minor

  • Light exercise
    Light exercise

    Minor

  • Heavy exercise
    Heavy exercise

    Minor

  • Light work
    Light work

    Minor

  • Heavy work
    Heavy work

    Minor

  • Intimate
    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.


Braces & Wedges Microfractures