{"id":23476,"date":"2020-09-25T17:08:44","date_gmt":"2020-09-25T09:08:44","guid":{"rendered":"https:\/\/www.columbiaasia.com\/malaysia\/?post_type=health-article&#038;p=23476"},"modified":"2025-05-20T09:16:24","modified_gmt":"2025-05-20T01:16:24","slug":"intra-articular-injection-in-the-treatment-of-knee-osteoarthritis","status":"publish","type":"health-article","link":"https:\/\/www.columbiaasia.com\/malaysia\/health-articles\/intra-articular-injection-in-the-treatment-of-knee-osteoarthritis\/","title":{"rendered":"Intra-Articular Injection in the Treatment of Knee Osteoarthritis"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"23476\" class=\"elementor elementor-23476\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b92652c e-con-full e-flex e-con e-parent\" data-id=\"b92652c\" data-element_type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f1e3b51 elementor-widget elementor-widget-text-editor\" data-id=\"f1e3b51\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>Knee osteoarthritis (OA), is a degenerative joint disease, typically the result of wear and tear and progressive loss of articular cartilage. OA is common in elderly persons and a major cause for disability. The intensity of the clinical symptoms may vary with everyone, but it typically becomes more severe and debilitating over time. The rate of severity and progression varies for each individual, and so their clinical symptoms and knee pain. The prevalence of knee OA will continue to increase as life expectancy, and obesity rises. Studies have found that the majority of the OA patients were asymptomatic, although with radiographic findings.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8a7171c jteHAblockquote elementor-widget elementor-widget-text-editor\" data-id=\"8a7171c\" data-element_type=\"widget\" id=\"padding-li\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p style=\"text-align: center;\"><strong>Did you know<\/strong><br \/>Pain is the hallmark symptom of osteoarthritis<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ffb2b8a elementor-widget elementor-widget-spacer\" data-id=\"ffb2b8a\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-column .elementor-spacer-inner{height:var(--spacer-size)}.e-con{--container-widget-width:100%}.e-con-inner>.elementor-widget-spacer,.e-con>.elementor-widget-spacer{width:var(--container-widget-width,var(--spacer-size));--align-self:var(--container-widget-align-self,initial);--flex-shrink:0}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container,.e-con>.elementor-widget-spacer>.elementor-widget-container{height:100%;width:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer{height:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner{height:var(--container-widget-height,var(--spacer-size))}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty,.e-con>.elementor-widget-spacer.elementor-widget-empty{position:relative;min-height:22px;min-width:22px}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon,.e-con>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon{position:absolute;top:0;bottom:0;left:0;right:0;margin:auto;padding:0;width:22px;height:22px}<\/style>\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6808105 elementor-widget elementor-widget-heading\" data-id=\"6808105\" data-element_type=\"widget\" id=\"subtopic01\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h3 class=\"elementor-heading-title elementor-size-default\">Risk factors for knee OA<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c3f1b53 elementor-widget elementor-widget-jet-table\" data-id=\"c3f1b53\" data-element_type=\"widget\" data-widget_type=\"jet-table.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"elementor-jet-table jet-elements\">\n\t\t<div class=\"jet-table-wrapper\">\n\t\t\t<table class=\"jet-table jet-table--fa5-compat\">\n\t\t\t\t<thead class=\"jet-table__head\"><tr class=\"jet-table__head-row\"><th class=\"jet-table__cell elementor-repeater-item-f973942 jet-table__head-cell\" scope=\"col\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\">Modifiable<\/div><\/div><\/div><\/th><th class=\"jet-table__cell elementor-repeater-item-627b40b jet-table__head-cell\" scope=\"col\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\">Non-modifiable<\/div><\/div><\/div><\/th><\/tr><\/thead>\n\t\t\t\t\t\t\t\t<tbody class=\"jet-table__body\"><tr class=\"jet-table__body-row elementor-repeater-item-9eeeb6f\"><td class=\"jet-table__cell elementor-repeater-item-2313287 jet-table__body-cell\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\"><ul><li>Occupation &#8211; prolonged standing and repetitive knee bending<\/li>\n<li>Weight<\/li>\n<li>Health &#8211; metabolic syndrome<\/li>\n<li>Muscle weakness or imbalance<\/li>\n<li>Articular trauma<\/li>\n<\/ul><\/div><\/div><\/div><\/td><td class=\"jet-table__cell elementor-repeater-item-d9dc6ec jet-table__body-cell\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\"><ul><li>Age<\/li>\n<li>Genetics<\/li>\n<li>Gender &#8211; females more common than males<\/li>\n<li>Race<\/li>\n<\/ul><\/div><\/div><\/div><\/td><\/tr><\/tbody>\n\t\t\t<\/table>\n\t\t<\/div>\n\n\t\t<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d84be54 elementor-widget elementor-widget-spacer\" data-id=\"d84be54\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-acc01cb elementor-widget elementor-widget-text-editor\" data-id=\"acc01cb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>The treatment for OA can be classified from the conservative approach to ultimately surgical treatment options. Intra-articular (IA) treatment for osteoarthritis (OA) is a non-surgical treatment option. This non-surgical intervention does not alter the underlying disease process but may substantially diminish pain and disability. Intra-articular injections may be useful for symptomatic knee osteoarthritis, especially where there is a considerable inflammatory component. The different intraarticular injection is corticosteroids, viscosupplements and blood-derived products.<\/p><p>The delivery of the corticosteroid directly into the knee may reduce local inflammation associated with osteoarthritis and minimize the systemic effects of the steroid. Whereas the other injectable option, the hyaluronic acid (HA) injections is a glycosaminoglycan that is found throughout the human body and is an important component of synovial fluid and articular cartilage. HA injection into the joint acts as a lubricant and may help to increase the natural production of HA in the joint.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0b90f95 e-con-full e-flex e-con e-child\" data-id=\"0b90f95\" data-element_type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[{&quot;_id&quot;:&quot;ec7c150&quot;,&quot;jet_parallax_layout_image&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_speed&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:50,&quot;sizes&quot;:[]},&quot;jet_parallax_layout_type&quot;:&quot;scroll&quot;,&quot;jet_parallax_layout_direction&quot;:null,&quot;jet_parallax_layout_fx_direction&quot;:null,&quot;jet_parallax_layout_z_index&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x&quot;:50,&quot;jet_parallax_layout_bg_x_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y&quot;:50,&quot;jet_parallax_layout_bg_y_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size&quot;:&quot;auto&quot;,&quot;jet_parallax_layout_bg_size_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_animation_prop&quot;:&quot;transform&quot;,&quot;jet_parallax_layout_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;]}]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bb2eaa7 elementor-widget elementor-widget-image\" data-id=\"bb2eaa7\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"403\" height=\"300\" src=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/03\/health-article-intra-articular-injection-banner-3.png\" class=\"attachment-full size-full wp-image-23481\" alt=\"\" srcset=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/03\/health-article-intra-articular-injection-banner-3.png 403w, https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/03\/health-article-intra-articular-injection-banner-3-300x223.png 300w\" sizes=\"(max-width: 403px) 100vw, 403px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6996368 elementor-widget elementor-widget-spacer\" data-id=\"6996368\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e2d37b9 elementor-widget elementor-widget-text-editor\" data-id=\"e2d37b9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Osteoarthritis is the most common type of arthritis, and generally, the chances of developing osteoarthritis rises after age 45 with the knee being one of the most affected areas. The most common cause of osteoarthritis of the knee is age, and Malaysia is fast developing into an ageing society. InfoMed sat down with Dr Ang Hock Leong, Consultant Orthopedic and Joint Replacement Surgeon, Columbia Asia Hospital &#8211; Klang to understand the medical options available for the treatment of osteoarthritis, precisely the non-surgical option.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ceb6b9a elementor-widget elementor-widget-spacer\" data-id=\"ceb6b9a\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-793bdcd elementor-widget elementor-widget-heading\" data-id=\"793bdcd\" data-element_type=\"widget\" id=\"subtopic02\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Common adverse effects of IA corticosteroid injection and IA HA injection<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bd70234 elementor-widget elementor-widget-jet-table\" data-id=\"bd70234\" data-element_type=\"widget\" data-widget_type=\"jet-table.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"elementor-jet-table jet-elements\">\n\t\t<div class=\"jet-table-wrapper\">\n\t\t\t<table class=\"jet-table jet-table--fa5-compat\">\n\t\t\t\t<thead class=\"jet-table__head\"><tr class=\"jet-table__head-row\"><th class=\"jet-table__cell elementor-repeater-item-f973942 jet-table__head-cell\" scope=\"col\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\">Intra-Articular Corticosteroid Injection<\/div><\/div><\/div><\/th><th class=\"jet-table__cell elementor-repeater-item-627b40b jet-table__head-cell\" scope=\"col\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\">Intra-Articular HA Injection<\/div><\/div><\/div><\/th><\/tr><\/thead>\n\t\t\t\t\t\t\t\t<tbody class=\"jet-table__body\"><tr class=\"jet-table__body-row elementor-repeater-item-9eeeb6f\"><td class=\"jet-table__cell elementor-repeater-item-2313287 jet-table__body-cell\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\"><ul><li>Infections<\/li>\n<li>Allergic reaction<\/li>\n<li>Pain and swelling<\/li>\n<li>Skin discoloration at the site of injection<\/li>\n<li>Elevated blood sugar<\/li>\n<\/ul><\/div><\/div><\/div><\/td><td class=\"jet-table__cell elementor-repeater-item-d9dc6ec jet-table__body-cell\"><div class=\"jet-table__cell-inner\"><div class=\"jet-table__cell-content\"><div class=\"jet-table__cell-text\"><ul><li>Fever<\/li>\n<li>Muscle pain<\/li>\n<li>Injection site pain<\/li>\n<li>Trouble walking<\/li>\n<li>Chills<\/li>\n<li>Headache<\/li>\n<\/ul><\/div><\/div><\/div><\/td><\/tr><\/tbody>\n\t\t\t<\/table>\n\t\t<\/div>\n\n\t\t<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76e318d elementor-widget elementor-widget-spacer\" data-id=\"76e318d\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4fae60f elementor-widget elementor-widget-heading\" data-id=\"4fae60f\" data-element_type=\"widget\" id=\"subtopic03\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Clinical symptoms of knee osteoarthritis \u2013 knee pain<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-20b1f26 elementor-widget elementor-widget-text-editor\" data-id=\"20b1f26\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul><li>Worsening overtime<\/li><li>Worse with prolonged activity<\/li><li>Worse with inactivity<\/li><li>Worse with repetitive bending or stairs<\/li><li>Better with rest<\/li><li>Better with ice or anti-inflammatory medication<\/li><li>Knee stiffness<\/li><li>Knee swelling<\/li><li>Decreased ambulatory (walkabout) capacity<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ece5597 jteHAblockquote elementor-widget elementor-widget-text-editor\" data-id=\"ece5597\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p style=\"text-align: center;\"><strong>Did you know<\/strong><br \/>Studies have shown multiple times injections of steroids which are powerful anti-inflammatory drugs, in the long term can cause further cartilage to thin out.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-de6333a elementor-widget elementor-widget-spacer\" data-id=\"de6333a\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bab592b elementor-widget elementor-widget-heading\" data-id=\"bab592b\" data-element_type=\"widget\" id=\"subtopic04\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">An interview with Dr. Ang Hock Leong, consultant orthopedic, trauma & joint replacement surgeon \u2013 Klang<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d76efc6 elementor-widget elementor-widget-text-editor\" data-id=\"d76efc6\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"color: #1b3087;\"><strong>Who are the best candidates for intra-articular injection?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Mild to moderate knee osteoarthritis usually respond well with hyaluronic acid (HA), platelet-rich plasma (PRP), or combination of both.<\/p><p>\u00a0<\/p><p><strong><span style=\"color: #1b3087;\">How long does an intra-articular injection last?<\/span><\/strong><\/p><p><strong>Dr Ang:<\/strong>\u00a0Studies have shown that HA and PRP can last more than six months. In my practice, most patients do it annually.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Does this procedure require hospitalization?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0It is usually done as an outpatient or daycare procedure.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Is there any post-injection physiotherapy requirement?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Usually, there will be slight swelling post-injection, and patients are advised to do regular cold pack and elevation for the first few days. Physiotherapy is helpful for osteoarthritis in terms of pain relief, reduce stiffness and thigh muscle strengthening.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Intra-articular injection is a steroid. Any side-effects?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Intra-articular steroid injection can provide an excellent anti-inflammatory effect. It is usually done for acute exacerbation of osteoarthritis or inflammatory arthritis like rheumatoid arthritis and gouty arthritis. Since it is injected into joint space, systemic absorption into the bloodstream is minimal to cause systemic side effects. However, studies have shown multiple times injections of steroid in the long term can cause further cartilage thin out.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Is age a factor in considering intra-articular injection as an alternative to TKR?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Yes. For a patient who is too young for TKR, or elderly who has multiple medical co-morbidities who is unfit for surgery.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Older adults often have complex and multiple disorders. As a surgeon, how do you view your challenges in improving the quality of life of older people?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0TKR is proven to improve the quality of life of knee osteoarthritis patient. However, every surgery carries certain risks and possible complications, especially in elderly who has multiple medical co-morbidities. Recent medical advancement has allowed pretty decent control over multiple chronic disorders, improvements in surgical techniques, advancement in materials, and instruments have lead to shorter operation time, less bleeding, lower infection rates. Better implant design improves longevity and addresses osteoporotic bone in elderly. In general, post-operation recovery is faster, and shorter rehabilitation process has reduced other risks like deep vein thrombosis, improve surgical outcomes and implant longevity, and subsequently better quality of life. In my practice, if medical co-morbidities are reasonably controlled, and surgical benefits outweigh the risks, surgery is still my preferred choice of treatment.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Are there any restrictions for doing an intra-articular injection?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Generally, if there is active knee infection, the injection should not be given. In my practice, do not give HA\/PRP during acute exacerbation of arthritis except steroid to avoid excessive swelling and pain. The injection should not also be given if the patient is allergic to the component of HA \/PRP.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Are the options and the personal goals of the patient discussed in arriving at the best treatment?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Good clinical practice should always explore patient expectations before the commencement of any treatment plan. Current evidence does not suggest intra-articular injection as a cure for knee osteoarthritis. It is merely an adjunctive to ease symptoms and functions. There are still non-invasive and non-pharmacological options available like weight reduction, activities modification, low impact exercises, applying topical NSAIDs, rest, walking aid and oral pain killer during bad days etc., and of course a more proven treatment method, TKR.<br \/><br \/>In my practice, patients are always informed regarding the effectiveness of intra-articular injection, which may not last long, or it may not be effective at all before they consented for the procedure. Available options are always discussed at the same time.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>Can you tell us about platelet-rich plasma use in intra-articular injection?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Platelet-rich plasma or PRP, a mixture of high concentration of platelet and associated growth factors, derived from the centrifugal separation of patient own whole blood or other persons whole blood. It is injected into the knee joint in the hope of promoting healing in wear and tear joint. More and more studies have shown promising outcomes of PRP, especially in younger patients. However, further studies still needed to determine the details like optimum preparation methods, volumes, concentration etc.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>The key symptom of knee osteoarthritis is pain. What are the options available with intra-articular injection in minimizing this pain?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Hyaluronic acid (HA), is the natural collagen in our connective tissue. The function is providing cushioning, lubricating and viscous effects in knee joints. HA injection or viscosupplementation is to replace or supplement the progressive loss of HA in osteoarthritis knee. It can be avian derived or produced via bacteria fermentation. The higher molecular weight variant (more than 1 million Dalton) is shown to be more effective. It is also shown to be more effective when used in combination with intra-articular steroid.<br \/><br \/>Intra-articular steroid injection is very effective in treating the pain during acute exacerbation of osteoarthritis or inflammatory arthritis like rheumatoid and gouty arthritis.<br \/><br \/>Intra-articular stem cell injection. The mesenchymal stem cell is used in intra-articular knee injection with the hope that stem cell will proliferate and differentiate into cartilage to replace and repair the damaged host cartilage. These cells are usually sourced from patient own bone marrow aspirates, adipose tissue, or peripheral blood. Although many active studies are ongoing, there is still no strong evidence to suggest the stem cells as a cure to osteoarthritis. In fact, there is still a lot of debate going on regarding its efficacy, cell harvesting, processing, characterization and delivery.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>In intra-articular injection, are there any risks that might overshadow their potential benefits?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Although it is a minimally invasive outpatient procedure, but a small risk of introducing infection into the joint cavity still possible. It may cause skin redness, skin irritation over the injection site, especially avian derived HA if the patient is allergic to avian products.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>What about the recovery and regain process after the intra-articular injection?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Most patients will have some knee swelling post-injection which may last a few days, but they are generally able to walk independently immediately after injection. They are advised to use a cold pack and elevate the knee when at rest. It is not advisable to receive this treatment too near to their planned trip or vacation.<\/p><p>\u00a0<\/p><p><span style=\"color: #1b3087;\"><strong>What are the current challenges in intra-articular injection for the treatment of knee osteoarthritis?<\/strong><\/span><\/p><p><strong>Dr Ang:<\/strong>\u00a0Efficacy of intra-articular injection is not consistent, and a lot of time is short-lived. We do not know exactly which patient will respond well even though they are in the same stage of the disease. We also do not know how long it will last. Intra-articular injections are still not a cure to osteoarthritis as none of them have shown to replace or to regenerate cartilage especially in advance stage of osteoarthritis and also in the elderly who usually do worse when it comes to tissue regeneration capacity.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-34087b9 elementor-widget elementor-widget-spacer\" data-id=\"34087b9\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-64bf17b elementor-widget elementor-widget-text-editor\" data-id=\"64bf17b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><em>This article first appeared in InfoMed Malaysia, Issue 34, Jul &#8211; Sep 2020.<\/em><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Knee osteoarthritis (OA), is a degenerative joint disease, typically the result of wear and tear and progressive loss of articular cartilage. OA is common in elderly persons and a major cause for disability.<\/p>\n","protected":false},"author":2,"featured_media":23480,"template":"","topic":[154],"language":[137],"class_list":["post-23476","health-article","type-health-article","status-publish","has-post-thumbnail","hentry","topic-orthopedics","language-en"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Intra-Articular Injection in the Treatment of Knee Osteoarthritis - Columbia Asia Hospital I Private Hospital in Malaysia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.columbiaasia.com\/malaysia\/health-articles\/intra-articular-injection-in-the-treatment-of-knee-osteoarthritis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Intra-Articular Injection in the Treatment of Knee Osteoarthritis - Columbia Asia Hospital I Private Hospital in Malaysia\" \/>\n<meta property=\"og:description\" content=\"Knee osteoarthritis (OA), is a degenerative joint disease, typically the result of wear and tear and progressive loss of articular cartilage. 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