Intra-articular injections in the knee joint are the best drugs

Joint injections are the most effective method of administering pharmacological agents. With it, you can deliver the right drugs directly to the inflamed synovial cavity or to the destroyed articular cartilage. The bioavailability of drugs administered this way is 100%.

Intra-articular injections are effective in treating deforming arthrosis, severe arthritis, synovitis and bursitis. For the introduction into the synovial cavity, several groups of drugs are used (steroid hormones, chondroprotectors, hyaluronic acid preparations). Injections are performed by a specially trained medical professional. The procedures are most often performed on an outpatient basis.

For the treatment of diseases of the knee joint, not only intraarticular, but also periarticular injections of corticosteroids are used. In the second case, drugs are injected into the periarticular tissues.

Table 1. Preparations for intraarticular injection into the knee joint

Group Action Disadvantages
Corticosteroids Effectively relieve inflammation in the knee, have a moderate analgesic effect. Act fast, but not for long They remove symptoms, but do not hinder the development of diseases of the knee joint. With prolonged use, adversely affect articular cartilage, exacerbating the course of arthrosis
Chondroprotectors They have a structurally modifying effect, contribute to the restoration of articular cartilage They act slowly, usually unable to completely restore the destroyed cartilage. Ineffective in the III-IV stages of arthrosis. Not suitable for quick relief of pain
Hyaluronic acid preparations Restore the normal composition and viscoelastic properties of synovial fluid They have a high cost, because of which not everyone can buy them. For a tangible effect, these drugs need to be administered 2-3 times a year

Learn to understand the difference between the active substance and the brand name of the drug. This will help you easily choose the most effective and cheapest drugs from those that were offered to you in the pharmacy.

Hydrocortisone

It belongs to the group of corticosteroids with a weak short-term effect, which is why it is rarely used for intraarticular administration. To achieve a pronounced therapeutic effect, a person needs to make several injections of the drug (and this is associated with a risk of injury to the joint and infection).

In orthopedic practice, the Hungarian drug Hydrocortisone-Richter is most often used. It is available in 5 ml vials. The medicine contains a corticosteroid hydrocortisone and a local anesthetic lidocaine. Thus, it has not only anti-inflammatory, but also a quick analgesic effect.

In pharmacies you can find various hydrocortisone-containing drugs in ampoules and vials. However, most likely there are no local anesthetics in their composition. Therefore, before administration, they will have to be diluted with Novocaine or Lidocaine.

Betamethasone

It is several times superior in strength to hydrocortisone. Preparations containing betamethasone have a prolonged effect (up to 4 weeks). To achieve a pronounced anti-inflammatory effect, it is enough to enter them 2-3 times a month (while hydrocortisone is injected several times a week).

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Medicines containing betamethasone as an active substance:

Betamethasone-containing drugs are usually more expensive than hydrocortisone-containing. Their price depends on the manufacturer and the volume of the ampoule or vial. For example, the cost of the American Diprospan is much higher than the Ukrainian Betaspan.

All corticosteroids have only a symptomatic effect. They relieve inflammation, but do not repair damaged cartilage, and with prolonged use they harm the joints. It has been proven that steroid hormones can disrupt the normal metabolism of cartilage. Their frequent intraarticular administration can aggravate the course of deforming arthrosis.

Triamcinolone

Refers to strong synthetic corticosteroids. With intraarticular administration, it is valid for several weeks. The medicine is usually injected 1-2 times a month. Most often, only one injection helps relieve pain and inflammation. In the pharmacy, triamcinolone is sold under the trade names Kenalog, Trikort, Kenalog-40, etc.

Before administration, all steroid preparations are diluted with local anesthetics (Lidocaine, Bupivacaine, Novocaine). This is to make the injection less painful. When anesthetics get into the tissue, they have a quick analgesic effect, thereby instantly improving the patient’s well-being. It becomes easier for a person almost immediately after an injection.

Even “neglected” joint problems can be cured at home! Just remember to smear it once a day.

Scientists conducted a study and found that periarticular administration of Triamcinolone is much more effective than intra-articular injections.

Alflutop

The only chondroprotector that can be used for intraarticular injection into the knee joint. The manufacturer of the drug is the Romanian company BIOTEHNOS. To date, the medicine has no full analogues.

Alflutop has anti-inflammatory and regenerative effects. It affects the metabolic processes in the articular cartilage, stimulating their recovery. Due to this, it is effective in the treatment of deforming osteoarthrosis and some chronic arthritis. The drug can not be used to stop acute inflammation.

When large joints are affected, Alflutop is injected into the synovial cavity in an amount of 1-2 ml. The course of treatment usually consists of five injections performed at intervals of 3 days. In some cases, doctors combine the intra-articular administration of the drug with its intramuscular injections.

All other existing chondroprotectors are available in the form of ointments, gels, tablets and solutions for intramuscular administration. According to most doctors, the latter are most effective. Some clinical studies have revealed the high efficiency of the simultaneous use of tablet and injection forms of chondroprotectors.

Sodium hyaluronate

Today in the pharmacy you can find many drugs containing hyaluronic acid. All of them have lubricating and shock-absorbing properties, provide soft and painless joint movement. They are injected exclusively into the joint cavity. Drugs in this group are called synovial fluid prostheses.

Unlike chondroprotectors, hyaluronate-containing agents have little effect on articular cartilage. However, they restore the natural composition and viscoelastic properties of the synovial fluid, preventing their destruction. These drugs act slowly, but have a powerful structural-modifying effect. After their introduction, the person’s well-being improves for several months.

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Ostenil

The drug of the German company Chemedika containing hyaluronic acid. Available in 2 ml syringes containing 20 or 40 mg of active ingredient. The medicine is administered once. In severe cases, the patient is given 2-3 injections with an interval of 14 days.

Sinocrom Forte

Another German drug based on sodium hyaluronate. It is made by the Kroma Pharma company. Available as a 2% solution in 2 and 4 ml syringes. The course of treatment with Sinokrom usually consists of 3 injections. Injections are done at intervals of one week.

Fermatron

Available as a 1% solution in 1 ml syringes. The manufacturer of the drug is Hayeltek, UK. A fermatron is inserted into the synovial cavity with an interval of 1 week. The course of treatment requires 5 injections.

Duralan

British preparation containing non-animal hyaluronic acid. Manufactured by Smith & Nefew. Release form – 3 ml syringes. 1 ml of the drug contains 20 mg of the active substance. The drug is administered once.

Haimovis

Italian drug. Manufactured by Phidia Pharmaceutici. The form of release of the drug is 3 ml syringes containing 24 mg of the active substance (HYADD * 4, sodium hyaluronate hexadecylamide). In the package there are immediately 2 syringes with medicine. The drug is administered 1 time per week. The course of treatment should not last longer than 3 weeks.

Shishkevich Vladimir
Shishkevich Vladimir
Orthopedic doctor, traumatologist
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I have been treating joints for many years. I can say with confidence that the joints are always treatable, even in the very ripe old age.

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Vladimir Shishkevich

Orthopedic surgeon, traumatologist, vertebrologist. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles. Diagnoses diseases of the musculoskeletal system, conducts treatment, monitors the healing process, recovery from injuries and operations, the application of immobilizing dressings, closed correction of dislocations and fractures.

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