What are the Options for Knee Injections vs. Knee Replacement?

What are the Options for Knee Injections vs. Knee Replacement?
Osteoarthritis (OA), a chronic condition that causes the cartilage between the joints to wear out, is the most prominent form of arthritis. The absence of cushion causes bones to rub and grind together, causing swelling, stiffness, and pain. Doctors may prescribe physical therapy, a knee brace, or oral medication. However, if a patent continues to experience severe pain, swelling or extensive joint damage, knee injections or a full knee replacement is recommended.


Osteoarthritis (OA), a chronic condition that causes the cartilage between the joints to wear out, is the most prominent form of arthritis.  The absence of cushion causes bones to rub and grind together, causing swelling, stiffness, and pain. Doctors may prescribe physical therapy, a knee brace, or oral medication. However, if a patient continues to experience severe pain, swelling or extensive joint damage, knee injections or a full knee replacement is recommended.

Knee Injection Therapy

Knee injection therapy is often recommended before surgery. The injection sometimes relieves knee pain for patients. The knee injection therapy options are as follows:

Hyaluronic acid supplements (viscosupplementation)

These are also called gel injections. A substance called hyaluronic acid is directly injected into the knee joint. The fluid acts as a shock absorber or lubricant, helping the joints regain proper functioning and easing pain and inflammation. An injection is administered weekly for 1 to 5 weeks depending on the product used. Common side effects of the gel injection are irritation, stiffness, swelling, pain and fluid buildup in the knee. Less common side effects are muscle pain, nausea, burning, blistering and bleeding.

Corticosteroid injections

The doctor injects corticosteroids directly into the knee joint to quickly ease pain and inflammation. The effects of this procedure may be felt instantly or several days after administering it. However, the results of the shot are temporary, lasting slightly over six months. Corticosteroids in large doses can, in some cases, cause undesirable side effects such as osteonecrosis (death of nearby bone), osteoporosis (thinning of bone), a temporary flare of pain and inflammation, nerve damage, or joint infection. Thus, this treatment is not recommended as a long-term solution for knee pain.

Knee Replacement

Although knee injection therapy can control pain and inflammation, the results are only temporarily. By contrast, knee replacement surgery is a permanent solution with excellent clinical outcomes. As OA advances, mobility and quality of life can worsen, leaving knee replacement surgery, also known as knee arthroplasty or knee "resurfacing," as the best solution.  During knee replacement surgery, the surgeon removes damaged bone and cartilage from the kneecap and then replaces this damaged bone with an artificial joint. The prosthesis is made out of technologically advanced materials such as metal, ceramic, or high-grade plastic and polymer components.

Delaying knee replacement surgery is associated with risks such as lack of mobility, increased pain, and deterioration of the joint. As with any surgery, risks such as nerve damage, heart attack, blood clots, and infection are possible, although uncommon. Exercise and physical therapy will help the patient to regain mobility quickly after this treatment. In sum, knee replacement surgery can be an excellent option to cure knee arthritis and allow you to return to an active, pain-free lifestyle.

For more information on knee replacement surgery or to schedule a consultation contact Dr. Dan Albright at 919-863-6808.