The main thing with arthrosis of the knee joint is to seek medical help at an early stage of the pathology. As soon as stiffness when moving after a long period of rest or pain after physical activity begins to appear, you should consult a doctor as soon as possible.
The use of complex therapy, which includes medication and physiotherapeutic components, as well as physical therapy and traditional medicine methods, can preserve the health and functionality of the knee joints for many years.
Osteoarthritis of the knee joint
These methods are also effective at stages 2-3 of arthrosis, but in this case it is necessary to pay attention to the way the joint tissues receive medications. The oral method is widely used (in the form of tablets, capsules, suspensions), but the injection route, mainly intramuscular, is more acceptable. According to indications, medications are also administered directly into the joint cavity.
Intramuscular injections for arthrosis of the knee joint are a sure way to keep the injected drug almost unchanged, in which it reaches the articular structures. After all, the tablet form of the drug or in the form of a suspension, entering the stomach, is exposed to hydrochloric acid, enzymes, and opportunistic microorganisms. The breakdown of the drug begins, as a result of which much less of it reaches the knee joint, and the products of drug metabolism cause side effects.
The intramuscular route of administration of the drug does not have these disadvantages, after which the active substances enter directly into the bloodstream and then very quickly into the knee joint. The doctor can be sure that the joint tissue will receive the entire administered dose, without the formation of decay products, and makes the appropriate calculation. The gastrointestinal tract does not suffer, its “useful” microflora remains intact and dysbiosis does not develop.
Injection of the drug intramuscularly
Drug treatment of arthrosis consists of painkillers, anti-inflammatory drugs, vitamins and chondroprotectors. First of all, it is necessary to relieve pain and active inflammation, since without this it is impossible to carry out either therapeutic gymnastic exercises or physiotherapy.
Painkillers and antispasmodics
For pain relief, injections of so-called analgesics and antispasmodics are made intramuscularly. Analgesics block the pain signal going to the cerebral cortex along the transmission path of nerve impulses. And antispasmodics eliminate tissue spasms, thus preventing the formation of a pain impulse initially.
Analgin or Baralgin are used as painkillers for arthrosis of the knee joint, the use of which has no contraindications. After the first intramuscular injection, the patient’s condition improves significantly due to the complete elimination of pain. Among the antispasmodics, Sirdalud, Mydocalm, Baclofen are widely prescribed as a course. They eliminate not only pain, but also the feeling of discomfort and stiffness in the knee joint, and restore freedom of movement in it. It should be taken into account that antispasmodics are not indicated during gestation and lactation, as well as in case of allergy to the drug component.
The most important component of drug therapy for arthrosis is non-steroidal anti-inflammatory drugs. These include the well-known Diclofenac, Ibuprofen, Piroxicam, Ketonal, which reduce the activity of the inflammatory process in the tissues of the knee joint. When administering them intramuscularly, it should be taken into account that the injection form of many of them is thick and has an oil component (for example, Diclofenac). Therefore, their “resorption” in the muscle mass of the buttocks takes longer, and in very rare cases, the formation of an abscess is possible.
Nonsteroidal anti-inflammatory drug
In addition, even with the injection route of entry into the body, anti-inflammatory non-steroidal drugs can still negatively affect the mucous membrane of the stomach and intestines and affect the condition of the gallbladder and liver. Their long-term use can cause the formation of erosions and ulcers, so they are used only in short courses and under strict medical supervision. If the patient already suffers from erosive or ulcerative lesions of the gastrointestinal tract, then Diclofenac and similar drugs are contraindicated for him.
To smooth out the possible negative impact of drug therapy on internal organs, the patient is prescribed a course of intramuscular injections of vitamins. These are complex preparations Trigamma, Milgamma, Neurorubin, Combilipen, the main components of which are B vitamins.
In advanced cases of arthrosis of the knee joint, hormonal agents in the form of intramuscular injections can be used for very narrow indications. They must be used very carefully, since steroid drugs suppress the inflammatory process very well, but at the same time inhibit the regeneration of hyaline articular cartilage, blocking the formation of new chondrocytes. An example of such medications is Ambene.
Injections for arthrosis of the knee joint are prescribed not only intramuscularly, but also inside the joint (chondroprotectors, hyaluronic acid, steroids). In each case, the doctor individually calculates the dosage and treatment course.
Gonarthrosis is characterized by deformation and destructive processes in cartilage tissue with a chronic course. In this case, the patient’s mobility is impaired, which leads to a limitation of his ability to work.
Injections for arthrosis of the knee joint help relieve pain and restore the affected tissue.
During the remission phase, it is very important to normalize lifestyle and nutrition in order to extend this period for many years.
All joints have a surface covered with cartilage tissue. They are located in the synovial bursa, where they are moistened and nourished by synovial fluid. In its normal state, hyaline cartilage is smooth and elastic.
When metabolism is disrupted or other provoking factors arise, for example, excessive stress on the legs, the joint undergoes degenerative changes. Due to a lack of nutrients, self-regeneration starts with a temporary delay, which slows down the restoration of damaged tissues.
The layer of cartilage gradually becomes thinner, the secretion of synovial fluid decreases, which causes increased friction. Cartilage tissue is destroyed and replaced by connective tissue. There is a significant restriction of mobility, and over time, complete paralysis of the joint.
Osteoarthritis of the knee joint develops in stages. Each period has its own symptoms due to various changes in the structure of the cartilage. Degrees of disease:
Important! It is better not to delay contacting a doctor. When the first symptoms of the disease appear, you should consult a specialist, since arthrosis can be successfully treated only in the first two stages.
When treating arthrosis, many drugs are used in the form of ointments, gels, and tablets. But the most effective method is the use of injections. Many people ask doctors about what kind of injections they give and how they differ.
It should be noted that there are 2 types of them:
Unlike drugs in tablet form, liquid ones do not have such an aggressive effect on the gastrointestinal tract and are almost completely absorbed. External ointments and gels almost do not penetrate the joint structure, and with direct administration of the product, the medication acts directly in the affected area.
A group of drugs is used to relieve inflammation and swelling. These include:
Non-steroidal anti-inflammatory drugs relieve inflammation, quickly relieve pain and swelling. They are prescribed in a short course. The disadvantage is a significant negative impact on the gastrointestinal tract.
Therapy with them is contraindicated for gastritis and ulcers, since NSAIDs provoke the formation of erosions on the gastric mucosa. They are not prescribed for pathologies of the liver and gall bladder.
If the duration of therapy exceeds 5-7 days, then it is necessary to take Maalox, Phosphalugel, and B vitamins in complex therapy.
The prescription occurs in cases where NSAIDs do not cope with their task or the joint is damaged quite severely. Any drug in this group is a good pain reliever and relieves inflammation. The disadvantage is that after such injections, the cartilage tissue loses its ability to produce new cells.
Indicated for relieving severe pain. They do not have a restorative effect. The course of treatment lasts one week.
Drugs in this group relax muscle fibers and relieve spasms. This way the affected area is numbed.
Injections of vitamins B1, B6 and B12 normalize metabolic processes, tissue nutrition, and improve the conductivity of nerve impulses. This treatment reduces pain.
The advantage of such injections is that they quickly relieve pain and stop the inflammatory process. This method is considered the best in the treatment of knee arthrosis.
The injection is performed directly into the problem area, which allows the drug to be activated in the first minutes without affecting the cardiovascular system and gastrointestinal tract. Intra-articular injections help restore cartilage tissue.
Representatives of the species are:
The doctor selects the type of drug, dosage and course of treatment individually, depending on the patient’s complaints, the stage of the disease, and the presence of complications. Independent procedures are contraindicated, as this can lead to disability for the patient.
Important! For synovitis, drugs are prescribed only after preliminary puncture of the accumulated contents.
Hormonal anti-inflammatory drugs help relieve inflammation, swelling and quickly relieve pain. The following are considered effective:
The first injection into the knee joint is a test one. If it does not bring relief to the patient, then the drug is replaced with an analogue. The dosage is selected separately for each patient. Frequency of administration: 1-2 injections every 14 days, no more than 5 injections per course. At the first injection, the maximum dose is used, after which the volume is reduced.
Side effects are observed with long-term use of drugs. They are caused by the destruction of cartilage tissue due to punctures of the structure, narrowing of blood vessels, muscle dystrophy, the emergence of dependence, the body can get used to constant support.
Corticosteroid is contraindicated in:
Injections for gonarthrosis are made with drugs aimed at restoring the structure of the damaged joint. The main active ingredients are chondroitin and glucosamine. Since their composition is similar to the components of the joint, the human body accepts them as native resources, activating tissue regeneration.
The patient's motor activity improves due to the normalization of tissue nutrition and the formation of synovial fluid.
Such drugs are effective when taken long-term. First, 12 to 20 injections are prescribed, then the patient is transferred to drugs of this series in the form of tablets.
The disadvantage of chondroprotectors is their high cost, which limits the range of consumers of this medication. Another disadvantage is that the use is advisable when the patient has 1 or 2 degrees of arthrosis. Injections when the condition is neglected will not bring the desired effect.
The most famous representatives of the class:
A contraindication is the situation when:
If there is insufficient lubrication in the joint, injections of hyaluronic acid are indicated. The product replaces intra-articular fluid, which serves to soften friction. The substance envelops the cartilage, creating a film on its surface, which restores the elasticity and firmness of the tissue. Injections are most effective at the initial stage of the pathological process. Usually 4-5 injections are sufficient.
Indications for use are grade 2 and 1 gonarthrosis and coxarthrosis. At stage 3, only slight relief occurs. The disadvantage is the high cost of the drugs. Side effects include blood thinning, temporary swelling and pain. Contraindications include egg white intolerance, pregnancy and breastfeeding.
Usually the doctor prescribes:
Important! In the presence of an inflammatory process, hyaluronic acid is ineffective. Injections should be carried out after a course of anti-inflammatory drugs.
This technique has not yet become widespread, however, it is quite effective and has almost no contraindications or side effects.
Treatment involves injecting blood plasma into the affected joint. To do this, venous blood is taken from the patient, after which it is purified and saturated with platelets using laboratory methods. The finished material is administered to the patient. This procedure allows you to naturally start the restoration of cartilage tissue and other structures of the body.
After relieving inflammation, injections of homeopathic remedies are recommended. The most popular are Traumeel S and Zel T. They help relieve pain and inflammation, strengthen the immune system, and trigger regenerative processes in the body. They are prescribed for coxarthrosis and osteoarthritis. Contraindication is individual intolerance to the drugs.
Manipulations are carried out to relieve pain in case of severe destruction of the joint. Swelling is relieved and mobility is restored. For infectious arthrosis, novocaine is combined with antibacterial agents.
Deforming osteoarthritis is a contraindication. One injection is enough for a period of 7 to 30 days, when the effect stops, you can re-administer.
Important. Novocaine injections cause fewer complications under the guise of vitamin therapy. They can be performed both in the joint cavity and in the soft tissues of the joint.
Intra-articular injections are most effective. Drugs are administered intramuscularly, which have virtually no therapeutic effect, but only reduce symptoms. The exception is vitamin complexes that normalize metabolic processes and tissue nutrition. The list contains the names of injections for direct injections into the joint and their brief description:
For arthrosis of the knee joint, injections can be performed intramuscularly and intraarticularly. Each type has its own indications. The first type is suitable for relieving pain and inflammation.
Injections into the joint help normalize the nutrition of the cartilage and restore mobility of the damaged area. The main condition is that the injections be performed by an experienced specialist on the recommendation of a doctor.
The destruction of cartilage in the knee area with arthrosis is accompanied by severe unbearable pain. This condition requires complex treatment, including, in addition to drug therapy and physiotherapeutic procedures, injections into the affected area. The latter method is considered the main one among many doctors, because injections into the knee joint for arthrosis instantly deliver the medicine to the problem area, where it immediately begins to act. Therefore, everyone who cares about the health of the musculoskeletal system should know about this method of treating arthrosis.
Normal functioning of the knee joint, its mobility, absence of discomfort - all these are the main conditions for human mobility. Meanwhile, the knees bear a lot of stress when walking. This becomes a factor in the development of serious pathologies even with a small focus of the disease.
In the worst case, the patient is faced with pathological deformation of the joint tissue, which is expressed in acute pain, inflexibility of the leg, and can even bind the patient to a wheelchair.
Therefore, such diseases require careful attention. And a timely injection at the initial stage of development of the disease can stop the development of destructive processes in tissues. In general, injections are indicated for the following diseases:
All these diseases are more common in older people, for whom it is common to have worn-out joints and worn-out cartilage. But it is precisely because of this that, in the absence of sufficient hydration and the required thickness of the cartilage layer, the tissue begins to rub, causing inflammation and swelling.
The basic principle is that the injected drug envelops the affected cartilage, acting as a kind of buffer between the elements of the joint rubbing against each other. Simultaneously with the mechanical effect, the medicinal components begin their work, which manifests itself in:
After a course of treatment with injections into the knee joint, if it turns out to be effective, pathological changes in the cartilage stop, the natural filling with synovial fluid is restored, as a result of which a person with arthrosis returns to a normal, full life. Moreover, this method of treatment instantly relieves pain and generally promotes recovery quite quickly.
Today there are three large groups of these drugs:
Which injections are suitable for the patient depends on the symptoms of the disease.
This group of drugs, in turn, is also divided into a number of varieties.
General strengthening therapy is carried out on the basis of intramuscular administration of B vitamins, for example, Copligam or Neurorubin.
The next group is distinguished by a direct method of delivering active components directly to the inflamed area, which provides instant action.
1) A type of corticosteroid drug eliminates foci of inflammation and severe pain in the fastest way. However, the disease itself cannot be cured with such drugs, because the administered substances do not contribute to the self-regeneration of cartilage. They lead to microcracks and increase the likelihood of concomitant infection. Because of this, corticosteroids (for example, Kenalog, Diprospan and Celeston) are administered no more than once every two weeks and only in the most severe forms of arthrosis as prescribed by the attending physician.
Drugs in this category are contraindicated:
2) A subgroup of chondroprotectors, which include Alflutop, Elbon, Chondrolone and other agents, fills cartilage with nutrients, helps accelerate the process of cell division and general restoration of joint functions. Traditionally, the course of treatment is 5–10 injections and is carried out after the inflammatory process has subsided. In case of deep tissue deformation, this type of drug will not bring significant benefit or will require long-term, expensive therapy over several months.
Chondroprotectors are close in composition to the natural tissues of the body, so they cause almost no complications or side effects and contribute to the rapid restoration of damaged areas.
3) Injections based on hyaluronic acid are designed to initially replace synovial intraknee fluid, and then contribute to its natural replenishment. This liquid is necessary for joints, as it nourishes them with microelements and accelerates cell division.
Preparations for injections into the knee joint for arthrosis with the addition of hyaluronic acid (Fermatron, Crespin and their analogues) become an artificial replacement for natural cartilage lubrication, contributing to the complete restoration of mobility without discomfort. But at a late stage of the disease, these medications do not always trigger the process of natural regeneration, although they can quite support the knee joints for a long time. But they are prohibited to be used only during pregnancy. They have no other contraindications.
To relieve acute pain, regular Novocaine or drugs based on it are injected into the knee area. This remedy will relieve the patient of pain, but it is worth understanding that it will not affect the course of the disease in any way. In addition, novocaine blockades require additional maintenance therapy with intramuscularly administered vitamin complexes. Also, you should not abuse analgesics. They are allowed to be administered no more than three times a month, otherwise this will lead to a series of complications.
Novocaine blockade is recommended for concomitant infectious lesions. In this case, antibiotics and antiseptics are administered along with an analgesic to eliminate pathogens from the source of infection.
If we compare therapeutic injections against arthrosis with other treatment methods, then this option has a number of significant advantages.
The medicine introduced with a needle will not lose its qualities during absorption into the body. Medicines immediately reach the site of inflammation and act on it as effectively as possible. It is recommended to use injections for arthrosis of the knee joint, as this will not lead to serious complications. Drug therapy, for example, leads to pathologies of the digestive organs, and intramuscular injections negatively affect soft tissues.
Another tangible advantage of this method in comparison with the same injections into the muscle area is their ease of tolerability. The administration of the product is not accompanied by severe pain, but the procedure has a number of subtle aspects that require the involvement of a professional physician. Without special education, it is not recommended to inject medications into the knee joint.
Thirdly, these methods are universal: they are used both during acute exacerbations of the disease and during long-term treatment of chronic arthrosis.
Finally, it should be noted that the effectiveness of drugs will greatly depend on the severity of the disease, as well as the selected subgroup of drugs. But we can highlight the general advantages of this method in comparison with others.
Despite the overall effectiveness of the treatment method, you should not rely only on injections for arthrosis. Complex therapy based on medications taken orally, ointments and gels, medical procedures, as well as restorative exercises in combination with injections will improve the patient’s condition much faster.
Moreover, the most effective drugs from this group are not cheap. For example, one injection of hyaluronic acid will cost 4–5 thousand rubles, while a course of treatment will require 16 injections. And most chondroprotectors cost in the range of 1500–2000 per ampoule. In this case, therapy involves around 20–25 procedures.
Thus, this treatment method is simply not available to many due to its high cost.
In addition to certain private contraindications, which differ for each type of therapeutic injection, there are also general ones, for which such therapy is strictly prohibited.
In cases where the injection does not produce a noticeable result, it is necessary to contact your doctor to clarify the diagnosis, since it is possible that the patient is following the wrong course of treatment.
The course of treatment is carried out in several stages.
Injections into the knee area allow you to treat arthrosis and restore lost cartilage tissue much more effectively than general drug therapy, because they act precisely on the main focus of the pathology. Depending on the course of the disease, one or another type of medication is used. To understand their diversity, general knowledge will not be enough. Therefore, arthrosis should be treated under the guidance of a specialist after performing the required set of tests.
Pain in the legs becomes unbearable for a person; injections into the knee joint for arthrosis can stop this. Although modern medicine has made great progress in recent years, the disease affects a large number of people in Russia and the world.
Irreversible and slowly progressive degenerative-dystrophic damage to the structures of the knee joint, during which the joint is completely destroyed, deformed or loses functionality, is called gonarthrosis.
Not only older people, but even those aged 20–30 are at risk. It is impossible to get rid of gonarthrosis. It is impossible to restore the cartilage inside the joint. But with proper treatment, the pathology stops developing at stages 1–2.
If its development is not prevented, the pain is constant and becomes unbearable, the joint loses its functions in full, which can only be restored with the help of knee replacement. Injections for arthrosis of the knee joint help eliminate pain.
Injections are given not only if a person has arthrosis manifestations. They are used if arthritic, adhesive-capsulitis or synovitis diseases develop, the joint is affected due to injury and for other reasons.
When manifestations of arthrosis develop with severe pain and inflammation, various injections into the knee help. Effective relief of the patient’s suffering occurs literally within 3–4 days.
Surgical intervention can be prevented with intramuscular injections. Treatment of the affected joints should be carried out immediately when the first signs of the disease appear. And only when it becomes clear that the disease is developing, intra-articular injections are used for arthrosis. These activities contribute to the complete cure of problems.
Injections for arthrosis of the knee joint have a number of advantages over other means of healing:
Elimination of arthrosis disease should be carried out in conjunction with physical therapy and physiotherapeutic measures, diet, medications and many others. But if they do not help, then a blockade of the knee joint is necessary for arthrosis.
Doctors prescribe ultrasound control for arthrocentesis of the knee joint (specialists gave the puncture this name). But research is possible without it. A professional visually controls the procedure if a puncture is performed, which significantly helps reduce the risk of developing an inflammatory process. If a puncture is not performed, then the doctor performs various manipulations blindly, according to his feelings and experience.
Arthrocentesis procedures are performed by qualified medical professionals in the operating room. It is imperative that the procedure be carried out in a hospital setting, under sterile conditions. The patient should lie on his back, with his knees straightened and relaxed. They should lie on a small cushion. This is necessary to relax the muscle section and fix the leg in the desired position.
Antiseptic solutions help in thoroughly cleaning the site where injections will be made into the knee joint. A specialist administers local anesthesia and injects lidocaine or another drug into the soft tissue area of the knee.
The puncture is performed using a syringe with a thin and long needle attached. An ultrasound helps the specialist determine the location where the puncture will be made. But the doctor can perform the procedure without the help of special equipment.
The puncture site is selected by a specialist after an ultrasound examination. Most often, the doctor pierces the side of the knee. A puncture is indicated here because the joint is closest to the surface of the skin, which means the needle can easily enter the muscle area, cartilage discs, ligaments and tendons. When the needle enters the joints, a characteristic dip is felt, which can be seen on the monitor of the ultrasound machine.
The specialist then removes the fluid in the knee, freeing up space for injected medications. If necessary, the joint cavity is washed with antiseptic or antibacterial solutions, and then the required dosage of medication is administered.
After administering medications, the needle is slowly removed, and the site where the injection was made is treated with antiseptic drugs, followed by application of a sterile bandage.
To reduce the risk of infection of the joint cavity during the procedure, before inserting the needle, the specialist should move the skin that is located above the puncture. When the needle is removed, the skin is lowered and returned to its place.
If injections into the knee joint occur in this way, the wound is covered with intact skin. This must be done so that infections do not directly enter the knee joints and arthrosis does not develop.
It is often possible to develop unpleasant consequences for human health, sometimes leading to death, so it is worth knowing for whom injections for arthrosis are contraindicated. This will help prevent the development of the disease and help cope with the disease without problems. Injection blockade of the knee is contraindicated:
Sometimes, after an injection is made into a joint for arthrosis, some complications may occur, including:
What kind of injections are given? This question interests many patients, so we need to dwell on it in more detail.
To eliminate inflammatory processes in the knee-joint area, injections into the knee joint are indicated using corticosteroid drugs, including Diprospan, Kenalog, Flosteron, Celeston. Such medications have a number of advantages. After using them:
But such injections for arthrosis of the knee joint are given only during an exacerbation of the disease, expressed by an inflammatory process with reactive synovitis. Such drugs are used in combination with other treatment methods.
It is worth following some rules when administering corticosteroids:
Before using corticosteroids, you should consult a specialist to avoid various health consequences.
Chondroprotectors are medications containing chondroitin sulfate and/or glucosamine, which help restore cartilage tissue. Drugs are prescribed in the modern world by many specialists, and patients leave only positive reviews after injections.
Medicines should be used outside of the inflammatory process. And injections with these drugs help slow down the progression of arthrosis. Today there are a whole variety of chondroprotectors, but the most popular are injections with: Dona, Chondrolon, Alflutop, Rumalon, Chondrogard. These drugs are usually used at the initial stage of arthrosis disease.
Hyaluronic acid is most effective in eliminating arthrosis manifestations. In the modern world, this remedy is used as an innovative technique, since it is used only for a 5-7 year period. Hyaluronic acid is called a “liquid prosthesis” because, when administered orally, it replaces the liquid intra-articular environment that nourishes and protects the cartilage, reduces friction between the 2 joints and helps slow down the destructive process in the knee.
With a hyaluronic injection into the knee joint, the depreciation of the cartilage tissue is restored, which means that the person stops feeling pain, the range of motion and partial knee functionality returns.
To solve problems, drugs containing hyaluronic acid are very helpful, the most popular of which are injections with Synvisc, Giastat, Fermatron, Ostenil, Sinokrom, Viskosil, Suplazin, Adant. The course of treatment should not exceed a 2-week period, but similar injections in the knees should be repeated no more than after a year and a half interval.
An innovative method in modern medicine is carboxytherapy. Carbon dioxide is injected into the joint through a special injection-pistol device. But it is necessary to strictly monitor its level, since an excess amount is regarded as a lack of oxygen level.
When the drug is administered, the blood flow becomes active, the delivery of oxygen to cellular structures increases, which means that cell nutrition improves and metabolism occurs quickly. Carbon dioxide is eliminated along with the blood.
Before various injections for arthrosis manifestations, you should consult a specialist by contacting a medical institution.
This will not only help prevent the development of arthrosis, but will also eliminate the unpleasant consequences for human health when self-medicating.
Treatment methods for arthrosis are varied; they can be divided into medicinal and non-medicinal. With drug therapy, the effect can be local or systemic. Preparations for external use - ointments, rubbing, solutions for compresses - have a local effect, and drugs for oral administration have a systemic effect. A special place among treatment methods is occupied by an injection into the joint for arthrosis. Treatment with injections is usually systemic, but when the drug is injected into the joint cavity, the effect is local. Intra-articular injections for arthrosis cannot always be classified as drug therapy, since not only pharmacological drugs are injected into the joints. Although this is a rather traumatic manipulation, it is more effective than many treatment methods.
Injections for arthrosis can be given intramuscularly (chondroprotectors, non-steroidal anti-inflammatory drugs, muscle relaxants, B vitamins) and intravenously (NSAIDs, drugs to improve microcirculation). But a number of drugs are intended for administration into the joint (intra-articular) or periarticular tissue (periarticular). Injection into the joint ensures the highest possible concentration of the active substance in the affected area, so a pronounced effect is quickly achieved. At the same time, the drugs penetrate into the bloodstream in small quantities, which reduces the risk of systemic side effects and reduces the drug burden on the body. And the therapeutic effect of intra-articular administration of some drugs lasts for six months or longer.
But this treatment of arthrosis also has disadvantages:
Any injection into a joint with arthrosis can only be performed as prescribed by a doctor; such manipulations require higher qualifications than for intramuscular injections. It is extremely important to ensure complete sterility; the injection site is treated like a surgical field, so such injections are usually not given at home.
What injections are given into the joint cavity and how do they work? The following can be administered intra-articularly:
Let's take a closer look at the principle of action of each group of drugs and the method of treating arthrosis.
Osteoarthritis and arthritis are among the most common joint diseases. Arthrosis, unlike arthritis, is not an inflammatory disease, but may be accompanied by an inflammatory process with intense pain. In acute cases, treatment of arthrosis with injections of non-steroidal anti-inflammatory drugs, which are administered intramuscularly and intravenously, as well as with the same drugs in tablets, is ineffective. Injecting the joint with glucocorticoids (adrenal hormones) quickly brings relief and helps stop the acute inflammatory process.
Hormonal drugs have a pronounced anti-inflammatory effect, but are not analgesics. Therefore, for severe pain, they are used in combination with local anesthetics, most often novocaine. Anesthetics also make the injection itself less painful.
The treatment regimen depends on the drug; the dosage is also affected by the size of the joint. Joint blockade for arthrosis is carried out using the following drugs:
Hormonal injections can aggravate degenerative-dystrophic processes in cartilage tissue, so they should be used only as indicated, do not exceed the dosage, and maintain an interval between injections. If after 2-3 injections there is no improvement, discontinuation (replacement) of the drug is necessary. Injections into the joint for arthrosis are not always possible. For example, at a late stage, with severe deformities, it is difficult to insert a needle into the joint cavity without resting on the bone. In such cases, they resort to periarticular administration of drugs; the effect has to wait longer. Before making injections into the inflamed joint, it is necessary to evacuate the exudate from the cavity. Blocking the knee and shoulder joints is technically much simpler than blocking the hip joint.
Hyaluronic acid is the main component of synovial fluid, responsible for its viscosity, and an important component of articular cartilage; it is also part of the skin and vitreous body. It is widely used in cosmetology as a filler, that is, a filler for wrinkles and folds. In ophthalmology it is used as a surgical medium.
For arthrosis, hyaluronate preparations serve as a substitute for synovial fluid; they are also called liquid prostheses. The development of arthrosis usually begins with a disruption in the production of intra-articular fluid by the synovial membrane. As a result, the cartilage experiences a deficiency of nutrients and fluid, dries out and begins to deteriorate. When arthrosis progresses, the synovial membrane degenerates and cannot cope with its functions. It can become pinched in the joint space and may be irritated by osteophytes, which leads to inflammation – synovitis. The joint cavity is filled with inflammatory effusion (exudate), it dilutes the intra-articular fluid and changes its characteristics.
Hyaluronic acid serves as a lubricant and shock absorber, nourishes and moisturizes cartilage tissue, covers the cartilage with a protective film, reduces friction at the articular ends of bones and prevents their accelerated wear and deformation. Its injections into a joint with arthrosis of the 1st degree can stimulate the production of synovial fluid, stop the destruction of cartilage and start the process of its regeneration. And even at a late stage (grade 3 arthrosis), liquid prostheses help restore joint mobility and eliminate pain. Injections of hyaluronic acid into the joint cavity for synovitis are ineffective, since its concentration decreases. So first you need to stop the inflammation so that exudate does not form.
The disadvantages of treatment with hyaluronic acid include its high cost; one dose for large joints costs at least 2,000 rubles. A course of treatment requires 3–5 injections at weekly intervals; to maintain the effect, 1–2 courses per year are required. The drugs are supplied in filled syringes, most often the syringe contains 2 ml of the drug, the concentration of the active substance varies from 0.9 to 2%, usually 1%. The most popular synovial fluid prostheses are:
Preparations of chondroitin, glucosamine and chondroprotectors with other compositions are available in different forms for oral, injection and external use. Injections to protect joints from destruction are considered more effective than taking tablets, since the active substances are not exposed to gastric juice. Most chondroprotectors, which are available in the form of an injection solution (Dona, Rumalon, Chondrolone, Mucosat, Biartrin, Chondroguard), are administered exclusively intramuscularly. There are 2 drugs that are used not only for intramuscular, but also for intra-articular administration, both belong to 1st generation chondroprotectors:
Alflutop restores the volume of synovial fluid, the thickness of articular cartilage, normalizes bone density, relieves inflammation, relieves pain, and improves metabolic processes. Intra-articular injections are indicated exclusively for arthrosis of large joints; they are performed at intervals of 3-4 days, a single dose is 1-2 ml. After 5-6 intra-articular injections, 20 intramuscular injections are performed, they are done daily, and a repeat course is given after six months. The drug is not recommended for use in the treatment of patients with seafood intolerance due to the increased risk of allergic reactions.
Arteparon stimulates the regeneration of cartilage tissue and joint membranes, the production of synovial fluid, suppresses the activity of enzymes that destroy cartilage, and improves its nutrition. It is prescribed for arthrosis of the knee joint and small joints of the fingers, but in the second case it is administered subcutaneously. And for gonarthrosis, both intramuscular and intra-articular injections are indicated. The latter are performed twice a week for 5 weeks, 0.5–1 ml is administered; for bilateral arthrosis of the knee joints, the total dose should not exceed 1 ml. The drug can cause allergic reactions, headache, shortness of breath, and increased heart rate.
A special method of treating arthrosis, occupying an intermediate position between drug and non-drug therapy, is gas injections. Injections of carbon dioxide (carboxytherapy) and ozone-oxygen gas mixture (ozone or oxygen therapy) are useful for joints. The ozone-oxygen mixture is used in medicine in different ways. It is passed through a saline solution, and then an ozone-enriched solution (OES) is administered intravenously by drip. During major autohemotherapy, venous blood taken from the patient is enriched with this mixture, which is reintroduced into the vein using a dropper. When administered intra-articularly, the best effect is produced by oxygen irradiated by a laser and transformed into a chemically active singlet state (photomodified ozone).