Non-operative Management of Osteoarthritis (OA) of the Knee: What Should you be Injecting Now and in the Future? (AANA19)-Cases_ Non-operative Management of Osteoarthritis (OA) of the Knee_ What Should you be Injecting Now and in the Future

Cases_ Non-operative Management of Osteoarthritis (OA) of the Knee_ What Should you be Injecting Now and in the Future_-Dr. John C. Richmond, M.D.

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Video Summary

The discussion centers on managing moderate knee osteoarthritis (OA) with various injection therapies. Initially, corticosteroid injections like Triamcinolone are common for flare-ups due to their effectiveness, low cost, and ease of use. If pain persists, biologic therapies such as Leukocyte-Poor Platelet-Rich Plasma (PRP) are considered next, though adipose-derived stem cells are reserved for stubborn cases unresponsive to other treatments. Proper diagnosis is emphasized, with MRI scans identifying pain sources like meniscal tears or bone marrow lesions that influence treatment choice. High molecular weight hyaluronic acid (HA) injections are preferred initially for many patients due to insurance coverage and non-invasiveness. Combining steroids with HA can prevent pseudoseptic reactions. PRP efficacy varies, often requiring only a single injection with reassessment after several months. For severe cases considering total knee replacement, conservative measures like HA or extended-release steroids (e.g., Zilretta) can delay surgery, especially for patients aiming to postpone arthroplasty.

Asset Caption

Instructional Course Lecture: Non-operative Management of Osteoarthritis (OA) of the Knee: What Should you be Injecting Now and in the Future?

Keywords

knee osteoarthritis

corticosteroid injections

platelet-rich plasma

hyaluronic acid

total knee replacement