Steroid Injections for Knee Arthritis

  1. The steroid injection is commonly recommended for knee arthritis as the medication is placed directly into the knee joint, will frequently last for three months or longer and reduces knee pain, swelling and inflammation. The injection allows the patient to avoid taking strong oral medications. If there is knee joint swelling (joint effusion and fluid in the joint) this is a sign that the joint synovial lining is reddened and inflamed, and a steroid knee injection is beneficial.
  2. The steroid injection takes only a few seconds and is not like a steroid injection in the foot or hand that may be painful. Over 95% of patients experience only a mild discomfort, although on occasion there may be a sharp pain that lasts for 3-5 seconds as with any injection.
  3. The success rate of a steroid injection is in 80-90% of patients who will have decreased pain and have a benefit. The problem is that some patients will receive 3 months benefit or longer and other patients receive only a week or two.  I only recommend a repeat injection after 3 months if this really helped the patient.  There is a maximum of 3 and perhaps 4 injections a year, however this is still a “band-aid” and I will not repeat the injections year after year.  Chronic recurring knee pain and dysfunction may indicate the need to move onto more definitive surgical solutions.
  4. The risks of a knee injection are very rare. The incidence of infection is less than 1 in 4000 injections as long as proper skin antiseptics are used.  Rarely a patient will say that the injection produced increased knee pain, or a feeling of general body aches, or in women an increased menstrual blood flow, which represents rare signs that the steroid medication has produced a side effect and fortunately these symptoms will disappear in 24-28 hours in my experience.  Even so they are reasons for not giving the steroid medication again.
  5. There is a rule that no surgery on the joint can be perfumed within 3 months of a joint injection to decrease any chance or risk of an infection with surgery.

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