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Therapeutic Joint Injections
Julia R. Crim, MD; Amy Powell, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Outcomes

        TERMINOLOGY

        • Abbreviations

          • Hyaluronic acid (HA)
          • Platelet-rich plasma (PRP)
        • Definitions

          • Injection of anesthetic, corticosteroid, HA, or PRP for treatment of joint pain

        PREPROCEDURE

        • Indications

          • Contraindications

            • Getting Started

              POST PROCEDURE

              • Expected Outcome

                OUTCOMES

                • Problems

                  • Complications

                    • Efficacy of Injected Agents

                      Selected References

                      1. Bowden DJ et al: Injectable viscoelastic supplements: a review for radiologists. AJR Am J Roentgenol. 209(4):883-888, 2017
                      2. Cole BJ et al: Hyaluronic acid versus platelet-rich plasma: a prospective, double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J Sports Med. 45(2):339-346, 2017
                      3. Dai WL et al: Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy. 33(3):659-670.e1, 2017
                      4. Trigkilidas D et al: The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain. Ann R Coll Surg Engl. 95(8):545-51, 2013
                      5. McCarrel TM et al: Optimization of leukocyte concentration in platelet-rich plasma for the treatment of tendinopathy. J Bone Joint Surg Am. 94(19):e143(1-8), 2012
                      6. TveitÄ EK et al: Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial. BMC Musculoskelet Disord. 9:53, 2008
                      7. Lambert RG et al: Steroid injection for osteoarthritis of the hip: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 56(7):2278-87, 2007
                      8. Robinson P et al: Clinical effectiveness and dose response of image-guided intra-articular corticosteroid injection for hip osteoarthritis. Rheumatology (Oxford). 46(2):285-91, 2007
                      9. Skedros JG et al: Variations in corticosteroid/anesthetic injections for painful shoulder conditions: comparisons among orthopaedic surgeons, rheumatologists, and physical medicine and primary-care physicians. BMC Musculoskelet Disord. 8:63, 2007
                      10. Ozturk C et al: The safety and efficacy of intraarticular hyaluronan with/without corticosteroid in knee osteoarthritis: 1-year, single-blind, randomized study. Rheumatol Int. 26(4):314-9, 2006
                      11. Qvistgaard E et al: Intra-articular treatment of hip osteoarthritis: a randomized trial of hyaluronic acid, corticosteroid, and isotonic saline. Osteoarthritis Cartilage. 14(2):163-70, 2006
                      12. Tehranzadeh J et al: Therapeutic arthrography and bursography. Orthop Clin North Am. 37(3):393-408, vii, 2006
                      13. Tehranzadeh J et al: Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review. Acta Radiol. 46(3):288-96, 2005
                      14. Kullenberg B et al: Intraarticular corticosteroid injection: pain relief in osteoarthritis of the hip? J Rheumatol. 31(11):2265-8, 2004
                      15. Eustace JA et al: Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rheum Dis. 56(1):59-63, 1997
                      16. Plant MJ et al: Radiographic patterns and response to corticosteroid hip injection. Ann Rheum Dis. 56(8):476-80, 1997
                      Related Anatomy
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Terminology

                        • Preprocedure

                          • Outcomes

                            TERMINOLOGY

                            • Abbreviations

                              • Hyaluronic acid (HA)
                              • Platelet-rich plasma (PRP)
                            • Definitions

                              • Injection of anesthetic, corticosteroid, HA, or PRP for treatment of joint pain

                            PREPROCEDURE

                            • Indications

                              • Contraindications

                                • Getting Started

                                  POST PROCEDURE

                                  • Expected Outcome

                                    OUTCOMES

                                    • Problems

                                      • Complications

                                        • Efficacy of Injected Agents

                                          Selected References

                                          1. Bowden DJ et al: Injectable viscoelastic supplements: a review for radiologists. AJR Am J Roentgenol. 209(4):883-888, 2017
                                          2. Cole BJ et al: Hyaluronic acid versus platelet-rich plasma: a prospective, double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J Sports Med. 45(2):339-346, 2017
                                          3. Dai WL et al: Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy. 33(3):659-670.e1, 2017
                                          4. Trigkilidas D et al: The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain. Ann R Coll Surg Engl. 95(8):545-51, 2013
                                          5. McCarrel TM et al: Optimization of leukocyte concentration in platelet-rich plasma for the treatment of tendinopathy. J Bone Joint Surg Am. 94(19):e143(1-8), 2012
                                          6. TveitÄ EK et al: Hydrodilatation, corticosteroids and adhesive capsulitis: a randomized controlled trial. BMC Musculoskelet Disord. 9:53, 2008
                                          7. Lambert RG et al: Steroid injection for osteoarthritis of the hip: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 56(7):2278-87, 2007
                                          8. Robinson P et al: Clinical effectiveness and dose response of image-guided intra-articular corticosteroid injection for hip osteoarthritis. Rheumatology (Oxford). 46(2):285-91, 2007
                                          9. Skedros JG et al: Variations in corticosteroid/anesthetic injections for painful shoulder conditions: comparisons among orthopaedic surgeons, rheumatologists, and physical medicine and primary-care physicians. BMC Musculoskelet Disord. 8:63, 2007
                                          10. Ozturk C et al: The safety and efficacy of intraarticular hyaluronan with/without corticosteroid in knee osteoarthritis: 1-year, single-blind, randomized study. Rheumatol Int. 26(4):314-9, 2006
                                          11. Qvistgaard E et al: Intra-articular treatment of hip osteoarthritis: a randomized trial of hyaluronic acid, corticosteroid, and isotonic saline. Osteoarthritis Cartilage. 14(2):163-70, 2006
                                          12. Tehranzadeh J et al: Therapeutic arthrography and bursography. Orthop Clin North Am. 37(3):393-408, vii, 2006
                                          13. Tehranzadeh J et al: Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review. Acta Radiol. 46(3):288-96, 2005
                                          14. Kullenberg B et al: Intraarticular corticosteroid injection: pain relief in osteoarthritis of the hip? J Rheumatol. 31(11):2265-8, 2004
                                          15. Eustace JA et al: Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rheum Dis. 56(1):59-63, 1997
                                          16. Plant MJ et al: Radiographic patterns and response to corticosteroid hip injection. Ann Rheum Dis. 56(8):476-80, 1997