At Complete our expert clinicians are highly experienced at carrying our ultrasound guided injections for osteoarthritis to provide rapid pain relief
In this article Luke Milward discusses the role of joint injections for osteoarthritis of the knee.
Over the past 18 months, under the shadow of the Covid-19 crisis, I have noticed a sharp increase in the number of patients attending Complete injections Cambridge complaining of worsening knee pain. Unfortunately, due to the current pandemic, patients suffering from muscle and joint issues have found it increasingly difficult to access the treatments they need to manage their pain and symptoms on the NHS. This has driven many people to seek out help privately.
About Osteoarthritis
Osteoarthritis of the knee is an extremely common cause of knee pain, mostly affecting people in their 5th decade onwards. It can cause the knee to become stiff and very painful, especially in the morning. The knee may also look bigger or swollen and can make clicking and cracking noises.
Osteoarthritis is a degenerative condition that affects the articular cartilage (inside surface) of the knee. Unfortunately, it is not feasible to reverse the degenerative changes caused by osteoarthritis however, it is possible to manage this condition using both physiotherapy and exercise. When physiotherapy and exercise alone are not enough to control your symptoms an injection can be used to reduce your pain, allowing you to increase your activity levels.
If you are unsure whether you have osteoarthritis in your knee but would like to know more, we would suggest you read our recent article here; Knee osteoarthritis.
Ultrasound Guided Injections
An ultrasound guided steroid injection used to treat osteoarthritis of the knee can be very helpful, reducing your pain and allowing you to move more freely. Research has shown that an injection, under ultrasound scanner guidance, is an accurate, safe and effective treatment modality.
Before we carry out an injection, an assessment and diagnostic ultrasound is always undertaken to ensure an injection is suitable. Furthermore, information gained from this process will allow for the most appropriate treatment to be selected.
There are a two main injection options available for the treatment of osteoarthritis of the knee at our Cambridge clinic. Both of these procedures are supported by medical literature.
- Corticosteroid injection. A corticosteroid is a strong anti-inflammatory medication used to reduce pain and inflammation. It is capable of reducing pain and increasing mobility in the joint very quickly with most people feel the benefits between a few hours and the first week.
- Hyaluronic acid injection. Hyaluronic acid is a synthetic replacement for the natural lubrication found within a joint. It also has anti-inflammatory properties. In fact the research has shown that hyaluronic acid injections for knee osteoarthritis can increase the longevity of the knee joint. Research has also shown that hyaluronic acid injections completed under guidance results in less cases of knee replacement surgery than unguided hyaluronic acid injections (Lundstrom etal., 2019).
John, a 55-year-old builder, shares his experience;
“I have been suffering from right knee pain for many years of. I am under the care of an NHS Orthopaedic consultant who diagnosed knee osteoarthritis with an x-ray and offered me a new knee however, I am only 65 and a very active and so do not want to go down this route just yet. I have been managing my knee pain with physiotherapy and daily exercises but during the first lockdown my activity levels dropped and my knee pain progressively got worse. I saw my GP who recommended a steroid injection but the waiting lists on the NHS were very long, and I did not want to wait. I was worried about how much a private injection would cost so did Google search and found Complete injections. The website looked very smart and the booking process was very slick. I had to fill in a consent form and I was contacted by Luke before my appointment to ask some questions. I felt very reassured by Luke and the Complete team.
“During my appointment Luke took a lot of time in care to listen to my story and assess my knee thoroughly. He showed me a large swelling at the back of my knee and suggested that we undertake an aspiration to remove the fluid. We also discussed using hyaluronic acid to preserve my knee joint and to allow me to push back the inevitable total knee replacement. I was surprised how quickly my knee felt better after Luke drew off the fluid from my knee. It took a week before the hydraulic acid kicked in and I have now been pain-free for 6 months. I would definitely recommend Luke and complete injections and will be returning for another hyaluronic acid injection when the time comes.”
Steroid or Hyaluronic Acid or Both
Both steroid and hyaluronic acid injections can be completed individually or in combination with one another and are always accompanied by a short acting local anaesthetic (to make the procedure as comfortable as possible). At Complete we found that the combination of steroid and hyaluronic acid can work very effectively. It is safe to inject both at the same time and this can provide a very effective treatment option. It can offers quick acting pain relief of the steroid and the longer lasting relief of hyaluronic acid.
An injection cannot reverse the degenerative changes within your knee, but it can reduce your symptoms and give you a window of opportunity to rehabilitate your knee. To gain maximum benefits from an injection, it is vitally important to restart your physiotherapy program to make sure your knee is as strong and as flexible as possible.
Knee Aspiration (draining any excess fluid on your knee)
Occasionally an arthritic knee can become very swollen. If this is the case an additional procedure called ‘Aspiration’ can be used. This involves removing the fluid from the knee. This can have a marked effect and many people say the knee feels lighter, more comfortable and less tight immediately after.
Affordable ultrasound guided injections
There is a commonly held belief that private ultrasound guided injections are very expensive. There are not many clinics within the U.K that can offer this ‘one stop’ service i.e. where you can receive an assessment, an ultrasound scan and an ultrasound guided procedure all in one appointment.
Many private hospitals do provide this service, but it is not uncommon to have to pay between £500-£1000). Due to the demands placed on the NHS by the Covid-19 pandemic, waiting lists for a guided injection are currently very long and some services are not offering them.
Complete injections Cambridge is in the heart of Cambridge, located in the grounds of Anstey Hall in Trumpington (just behind the Waitrose). We are located within the Coach House Health Care clinic. The clinic is easily accessible to locals and to people travelling from further afield. We are close to the M11 and a mile from Cambridge train station.
We regularly treat patients from Essex, Bedford, Suffolk, Norfolk and Lincolnshire but often see people coming from further away including Sheffield and the midlands.
Luke Millward is our clinical expert and leads our Cambridge service. He is a fully trained physiotherapist, musculoskeletal sonographer and injection therapist. He is also a fully qualified independent prescriber. Luke is able to accurately assess you and prescribe the most appropriate medication before completing the guided injection. All of this is done within one session. You do not need to have a referral from your doctor and can quickly and easily self-refer directly into our clinic.
If you are suffering from knee pain or would like to know more please feel free to contact us on 0207 4823875 or email injections@complete-physio.co.uk.