Types of Knee Injections
For patients with acute or chronic knee issues, there are a variety of safe injections for knee pain that may be able to offer a potential option for treatment. The Mayo Clinic notes that knee pain is one of the most common complaints for Americans. Knee pain can be caused by accident, overuse or injury. It can also be caused by aging and disease.
Osteoarthritis is the most common form of disease within the knee. Your knee is the largest and most complex joint in your body and it absorbs a lot of wear and tear over the years. You don’t have to be an ultramarathon runner to wear down this mighty hinge joint, it wears down simply by the general movement of your body.
As we age, the wear and tear on the joint increases, wearing away the cartilage. This can cause a great deal of pain for the patient! Once the cartilage deteriorates, it cannot be regenerated, leaving patients with limited options for alleviating their pain.
- Opiates and over-the-counter medications offer a short-term solution that can ease pain. However, patients can develop dependence and build a tolerance for the drugs, requiring stronger doses to maintain symptoms.
- Knee surgery or knee replacement are also risky for many patients and do not guarantee that pain will be managed. Recovery time can be lengthy and interfere with normal daily life.
Fortunately, patients seeking alternative pain management options to surgery or prescription and OTC medication have options. Medical research has made great progress in the development of several knee joint injections.
Knee injections have advanced beyond traditional steroid shots to encompass several other options. Treatments such as stem cell knee injections are still being studied for efficacy. However, with other promising treatments like hyaluronic acid injections, knee pain patients have reported improvement in their pain.
If you are interested in the potential benefits of knee injections for pain caused by osteoarthritis or other cartilage-impacting conditions, it is important to be informed about your options. This page will cover the types of shots available, common injection methods and frequently asked questions about knee injections.
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Types of Knee Injections
There are many different types of knee gel injection brands available to patients today. The option a patient selects will typically depend on the nature of their knee pain and the patient’s insurance coverage. The following is a list of knee injections and their function in alleviating knee pain. Please note that results may vary from patient to patient and the following list is for general information purposes.
Hyalgan knee injections for arthritis contain hyaluronate and function as a supplement to your body’s natural synovial fluid. As we age, synovial fluid can dissipate from the joint, reducing your body’s natural lubrication. Hyalgan injections are believed to help cushion the joint in the case of cartilage degeneration and improve the function of the joint by supporting replenishment of the body’s natural joint lubrication.
Hyaluronic Acid Injections
Hyaluronic acid injections are sold under a variety of brands. Hyaluronic acid is a gel-like substance that your body produces naturally. It helps the body maintain hydration and works as a lubricant for your joints. Harvard Health refers to hyaluronic acid as a humectant, meaning that it operates like a sponge, retaining necessary moisture in your body. The collection of hyaluronic acid brands may differ in their length of performance, sourcing and injection series. See the chart below for more information.
Orthovisc is a hyaluronic acid knee injection developed specifically for osteoarthritis of the knee. Orthovisc is given to the patient through a series of 3-4 injections. Orthovisc’s high molecular weight hyaluronan acts as a viscosupplement that may be able to support the body’s natural synovial fluid. Studies have shown that Orthovisc injections can last for up to 6 months.
Gelsyn 3 is a 3-shot series of hyaluronic knee injections that was developed to support the body’s natural joint lubrication and provide cushioning in the knee. Shots are administered over the course of one shot per week. Results can last up to six months.
Genvisc 850 is a non-surgical pain management injection for sufferers of arthritis/osteoarthritis. This viscosupplementation therapy utilizes the thick cushioning properties of hyaluronic gel to protect the joint and facilitate lubrication and mobility. Genvisc 850 is administered across 5 shots and can last up to 6 months.
Hymovis treatment is administered in two injections over two weeks, making it a quicker option than some of its counterparts. Hymovis is a repeatable treatment with doctor’s approval and has no known interactions with other common drugs. Hymovis is formulated to work as a shock absorber and lubricant in the knee joint.
Monovisc is a hyaluronic acid injection that does not contain viscosupplement from avian sources. Patients with allergies to eggs or avian products may find Monovisc to be a potential option for treating osteoarthritis in the knees. Monovisc does still offer similar potential benefits in supplementing the body’s natural synovial fluid.
Euflexxa is another hyaluronic injection that does not contain animal products. This provides another potential injection option for patients with allergies to animal products or avian products. Many hyaluronic acid injections are derived from rooster comb, making them dangerous for osteoarthritis patients with allergies to eggs or other avian/poultry products.
Synvisc knee injections are a hyaluronan treatment developed to manage pain by increasing lubrication in the knee and increasing the knee’s shock absorption. Synvisc is administered in three shots and can provide potential relief for up to six months.
Synvisc-One is the same injection as Synvisc. The only difference between the two injections is that Synvisc-One is administered with just one shot.
Supartz FX is a hyaluronic injection that has been clinically proven to be safe for repeated use. The injection manufacturer expanded the safety label to include guidance for repeat injection. Supartz FX is administered in 3-5 injections. However, the full five injections are recommended. The company also touts its injection as being the “affordable” and “flexible” option for osteoarthritis patients.
Durolane has the distinction of claiming to be the longest lasting hyaluronic injection based on several studies. Durolane is administered in a single appointment and patients have reported experiencing improvement in their pain as early as two weeks after the injection.
Trivisc is developed to diminish the impact of reduced synovial fluid caused by osteoarthritis. Trivisc is administered in 3 shots and lasts for up to 12 weeks. Trivisc has been shown to be comparable to injections like Euflexxa per published data.
Cortisone shots contain a corticosteroid that reduces swelling and inflammation in the affected joint. The initial injection usually causes pain in the joint for one to two days. After that, the pain-relieving effects can last for several months. However, prolonged use has been associated with deterioration of cartilage and other negative side effects. These side effects can increase with long-term use. You can learn more about cortisone shots here.
Common Methods for Knee Injections
There are two methods for knee injections. While both methods will be covered in this section, it is important to note that medically supervised injections guided by fluoroscopy technology are one of the safer, more precise options available to patients.
Medically Supervised, Fluoroscopic Injections
What Should I Expect when Getting Knee Gel Injections?
Knee injections should always be supervised by a medical doctor. Due to the precision required, a doctor should not administer without fluoroscopic guidance. For example, a National Institute of Health article on fluoroscopic-guided injections noted that only 12% of non-guided injections were successful. Here is what to expect during a medically supervised, fluoroscopic injection:
- You will be asked to show up to the out-patient appointment in clothing that allows you to expose your knee for the procedure.
- Your doctor will help you get into position on the X-ray table.
- The injection site is sterilized.
- If necessary, your doctor may apply an anesthetic.
- Your doctor may drain/aspirate excess fluid from your knee.
- Guided by fluoroscopy, your doctor will accurately administer your chosen knee injection.
- You will be provided with post-injection instructions with information about giving your knee(s) time to rest and instructions for when/if to contact your doctor.
Blind Needle Placement
As noted in the previous section, knee injections should be administered with fluoroscopic guidance. In a blind needle injection, the needle is placed using the best guess of the injector. This means that there is no guarantee that the gel has reached the proper area and there is not a simple way to determine if it has been administered properly.
Knee Injections And Insurance
One of the most common questions that patients ask about knee injections is whether or not insurance will cover a specific injection. it is important to get evaluated so your doctor can determine which type of knee injection product is best for you and is also covered by your insurance. We also have a self-pay option.
Frequently Asked Questions
Cortisone shots can last from as little as 6 weeks to as long as 6 months.
Knee injections may be covered by your insurance provider. Ask your doctor about steps you can take to request approval from your insurance company. Additionally, you can contact your insurance company to ask by using the number on your insurance card or in your healthcare paperwork.
The side effects of knee injections are typically pain in the injection site that can last for around 48 hours. That length of time can vary by patient. For injections such as cortisone, long-term use can lead to further cartilage damage and other issues within the joint.
Patients across many studies have reported positive results from knee shots such as hyaluronic injections. Knee gel injection reviews shared by patients are also a positive indicator of their success for osteoarthritis patients. Talk with your doctor to determine if you are a candidate for arthritis treatment with knee injections.
Hyaluronic acid injections have not been shown to cause weight gain.
The cost of your knee injections will depend on the brand selected and insurance co-payment. If you are a self-pay patient, your costs will also vary.
There is no single “best” injection for knee pain. While there are many different names of injections for knee pain, many of them contain similar components with subtle differences. For example, a patient with avian allergies will benefit from a Monovisc injection, while a different patient will be fine with any hyaluronic knee gel injection. For injections that are still being studied for efficacy like PRP injections, knee pain patients may wish to investigate further or await the results of more trials.
Knee injections can last anywhere from several weeks to several months. Check with individual brands to find the general length of time reported in clinical trials.
As noted above, knee injection patients have reported positive results months after receiving their injection series.
The Mayo Clinic reports several potential negative side effects associated with long-term cortisone injections.
A cortisone shot is a type of steroid injection.
Let's Talk Knee Injections
Knee injections are a promising potential option for patients who wish to alleviate knee pain caused by osteoarthritis or injury. Now that you have the information you need to make an informed decision about knee injections for your acute or chronic knee pain, it is time to schedule a consultation with your doctor to find out if you are a candidate for treatment and determine next steps.