Pain Management Procedures
Knee Joint Injections - Steroid, Hyaluronic Acid, and PRP
Knee Joint Injections - Steroid, Hyaluronic Acid, and PRP
What are knee injections?
Medication can be placed directly into the knee joint to reduce pain or inflammation. Corticosteroid is used for short-term control of inflammation. Hyaluronic acid, also called viscosupplementation, is an FDA-approved option for knee osteoarthritis after simpler treatment has not provided enough relief. PRP uses concentrated components of the patient's own blood.
When may they be recommended?
Injections may be considered for osteoarthritis or another confirmed joint condition. Joint fluid may be removed if the knee is swollen or if infection, gout, or another diagnosis is possible. Recommendations differ: some guidelines do not recommend routine hyaluronic-acid use because average benefit is limited, even though FDA-approved products remain available for selected patients. Evidence for PRP varies by preparation and severity of arthritis, and coverage is often limited.
What happens?
The knee is positioned and cleaned. Ultrasound may guide the needle, especially when fluid is present or anatomy is difficult. Fluid can be removed, then the selected medication is injected. PRP requires a blood draw and processing before injection. Some hyaluronic-acid products use one injection; others use a series.
What should I expect?
The knee may feel full or sore. Rest from strenuous activity as instructed. Steroid may work within days, hyaluronic acid more gradually, and PRP can cause a more noticeable temporary flare. None of these treatments regrows a normal joint surface.
Important risks
Risks include infection, bleeding, medication reaction, pain flare, and injury to nearby tissue. Steroid can raise blood sugar and repeated use may affect cartilage. Hyaluronic acid can cause a marked inflammatory reaction in uncommon cases. Injection timing should be coordinated if knee replacement is being considered.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.