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