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An intra-articular knee injection is a very effective form of treatment where medicine is delivered directly into the knee joint with the primary objective of relieving pain from conditions such as arthritis.

Intra-articular knee injections are usually recommended when the pain has not responded to traditional conservative treatments such as anti-inflammatory medications, physical therapy, activity modification.

There are various types of intra-articular injections. Depending on your condition, your doctor may recommend an intra-articular injection of: Hyaluronic acid is a naturally occurring substance in the joints that provides lubrication and acts as a shock absorber. With arthritis, this substance is largely deficient, leading to worsening of the condition. Hyaluronic acid injections into the knee can help reduce pain and improve range of motion.

Your doctor may perform an intra-articular injection of corticosteroids to reduce inflammation in the knee joint. Corticosteroids prevent the production of inflammatory cells that are naturally produced in response to an acute injury or arthritic conditions. Platelet-rich plasma or PRP is obtained from your blood and may be used in an intra-articular injection of the knee joint to encourage tissue regeneration, reduce pain and improve function.

Intra-articular knee injections may be performed using various approaches. During the procedure, you will be lie on your back with the affected knee flexed or extended. The skin over the injection site is sterilized and numbed with a local anesthetic.

The needle is inserted into your knee joint and the medication is injected. In some cases, ultrasound /image intencifier imaging is used to help guide the needle to the correct site. You may feel some mild discomfort during the injection. In some cases, prior to injecting the medicine, a small amount of joint fluid is withdrawn to make space for the medication. Once the fluid is removed, the same site is used to administer the intra-articular injection. A small dressing is then applied over the injection site to complete the procedure.

Postoperative care will include the following instructions:

• Avoid strenuous activities for a couple of days
• Apply ice on the injection site for comfort
• Rest, elevation and medicines are recommended to relieve pain and swelling
• Gentle range of motion exercises are recommended

Intra-articular knee injections are a relatively safe procedure. However, as with any procedure, there may be certain risks and complications such as:

• Infection at the injection site
• Reaction at the injection site
• Inflammation of the joint

Radiofrequency ablation (RFA) is a common interventional procedure, typically performed on the nerves in your spine. In the past few years, pain specialists have begun performing a modified version of this procedure on other joints like the knee.

RFA is a minimally invasive outpatient procedure and is typically used for pain from osteoarthritis, the most common form of arthritis, or a previous injury.

Radiofrequency ablation (RFA) uses radio waves to create a heat lesion around the genicular nerves. The genicular nerves are responsible for carrying pain signals from the knee to the brain. Usually performed under local anesthesia, a needle is guided to the genicular nerves using real-time X-ray technology. Once it has been established that the correct nerve is targeted, heat is applied to create a lesion that blocks pain signals.

Radiofrequency ablations can be a favorable option for those with debilitating joint pain because the recovery time is short, there is no incision and you can go to work the next day. Pain relief may last from nine months to two years. While the effects will eventually wear off as the nerves recover from the procedure, RFA can be repeated as necessary.

If traditional therapies such as physical therapy, weight loss, pain medications or steroid injections have not eased the pain, then RFA may be an alternative to surgery for patients who are unfit for a knee replacement or want to avoid the procedure.

RFA for chronic knee pain can be used as part of a complete treatment plan before knee replacement as it can provide enough pain relief to make physical therapy and exercises possible.

Patients who have had knee replacement surgery and still experience problems may also benefit.