Medical Procedures

Injections may be recommended for severe joint pain. It may be needed if other care options are not able to relieve pain or mobility problems. These procedures can give temporary relief. They may need to be repeated to maintain benefits. Injections may not be advised for all types of osteoarthritis (OA).

Intra-articular Corticosteroid Injections

Corticosteroids (steroids) can decrease inflammation and pain. It can be injected directly injected into the joint.

Steroid injections may be repeated every several months. Frequent use of steroids can cause a breakdown of tissue in the joint. Because of this, they are often limited to 3-4 injections in a year.

Viscosupplementation Injections

This injection uses a substance called hyaluronic acid. It is a chemical found in normal cartilage and joint fluid. The injections are believed to help lubricate the joint. It allows better gliding of the joint and decreases pain and stiffness.

Surgical Procedures

Surgery can not treat OA itself. It may be needed to repair, rebuild, or replace damaged joints. Surgery may help to:

  • Reduce or eliminate pain
  • Correct joint deformities
  • Restore mobility

Surgery is only recommended for those who don't have relief with other methods.

Arthroscopy

Several tiny incisions are made on or near the joint. A small lighted camera is inserted through one incision. Small surgical instruments are passed through a second incision. These instruments are used to clean out the joint. It may include removing shards of bone and cartilage that might be causing problems.

Osteotomy

This surgery helps to repair deformed joints. It is most often done for the knee, thigh bone, or leg bone. The joint will be realigned. It will change the balance of weight on the joint. The healthy areas of cartilage will then be able to bear more weight. This will put less pressure on the damaged tissue.

Arthroplasty

Arthroplasty replaces part or all of the damaged joint. It is more commonly referred to as a joint replacement. A synthetic joint or devices will be used. The replacement is often made of a chromium alloy and plastic. The replacement is done to decrease pain and improve function.

The knee and hip are the most common joints replaced.

Hip Replacement

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Knee Prosthesis

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Arthrodesis

Arthrodesis may be considered for those who have not had good pain relief from other efforts. It is considered as a last resort. The two bones of the joint are permanently fused together. It can greatly improve pain. However, it also prevents normal movement of the joint.

REFERENCES:

ACR issues recommendations on therapies for osteoarthritis of the hand, hip, and knee. Am Fam Physician. 2013;87(7):515-516.

Osteoarthritis (OA) of the knee. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116897/Osteoarthritis-OA-of-the-knee. Updated July 22, 2016. Accessed October 4, 2016.

Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Osteoarthritis/default.asp. Updated August 2013. Accessed December 1, 2014.

Osteoarthritis (OA) of the hip. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114846/Osteoarthritis-OA-of-the-hip. Updated July 22, 2016. Accessed October 4, 2016.

Sinusas, K. Osteoarthritis: Diagnosis and treatment. Am Fam Physician. 2012;85(1):49-56.

Last reviewed May 2018 by Warren A. Bodine, DO, CAQSM  Last Updated: 7/19/2018