PRP and Intra-Articular Injection Treatments for Knee Osteoarthritis

Intra-articular injection methods like PRP and hyaluronic acid used in treating knee osteoarthritis are modern medical approaches that reduce pain and improve mobility for patients seeking non-surgical solutions. These treatments aim to balance fluid loss in the knee, slow down the progression of cartilage damage, and enhance the patient's daily quality of life.

• PRP treatment involves injecting regenerative cells obtained from the patient's own blood into the knee.
• Hyaluronic acid injections reduce friction in the knee, increasing joint lubrication.
• Injection procedures are generally performed in an outpatient setting, take little time, and are relatively painless.
• The effectiveness of the treatment varies depending on the patient's age, the stage of osteoarthritis, and their weight.
• In advanced stages of osteoarthritis, surgical options are considered instead of injections.

What Are Knee Osteoarthritis and Intra-Articular Injections?

Medically known as osteoarthritis and commonly referred to as joint wear and tear, this is a condition where the cartilage tissue at the ends of the bones forming the joints wears down and thins over time. Cartilage acts as a cushion that allows the knee to move smoothly. When this tissue wears away, bones start rubbing against each other, leading to pain, swelling, and restricted movement. Intra-articular injections applied for knee fluid loss treatment step in right at this point.

Injections applied to the knee serve two main purposes: increasing joint lubrication and supporting the repair process of the damaged tissue. Hyaluronic acid injections provide mechanical relief by externally supplementing a substance similar to the knee's natural fluid. PRP treatment for the knee, on the other hand, triggers cellular healing by injecting platelet-rich plasma obtained from the patient's own blood into the joint. Osteoarthritis, which is particularly common in individuals over 40, can be kept under control for many years thanks to these injection treatments when caught in the early stages.

Causes and Risk Factors of Knee Fluid Loss and Osteoarthritis

The deterioration of the cartilage structure in the knee joint is not tied to a single cause; it usually emerges from a combination of genetic predisposition and environmental factors. The most fundamental risk factor is advancing age. The load carried by the knee joint over the years slows down the regeneration rate of cartilage cells. Besides this, excess weight is the biggest enemy of knee osteoarthritis. Every single kilogram increase in body weight reflects as approximately three to four kilograms of extra load on the knee during walking.

Past sports injuries, meniscus tears, cruciate ligament ruptures, or fractures around the knee can manifest as osteoarthritis years later. Furthermore, those who constantly work in a squatting position due to their profession, carry heavy loads, and have to go up and down stairs frequently during the day are at risk. In individuals with a family history of severe osteoarthritis, cartilage wear can begin at an earlier age. Flat feet or alignment disorders in the legs also cause disproportionate loading on one side of the knee, accelerating regional wear and tear.

Symptoms of Osteoarthritis: Which Complaints Appear at Which Stage?

Osteoarthritis is an insidious disease, and its symptoms vary according to the stages. In the initial stage, mild aching is usually felt in the knee after long walks or when carrying weights like heavy grocery bags from the local bazaar. Experiencing stiffness in the knees lasting less than half an hour when getting out of bed in the morning is a typical early-stage symptom.

When progressing to the middle stage, pain intensifies during movements where the knee is bent, such as going up and down stairs, using a squat toilet, or kneeling to pray. Crunching or grating sounds may start coming from the knee. From time to time, swelling and an increase in temperature can be observed in the knee. Especially in the winter months, joint pain significantly increases in cold weather.

In advanced-stage osteoarthritis, the pain continues even while resting or sleeping at night. The patient's walking distance is seriously shortened. Because the cartilage has completely worn away, the bone structure begins to deform, and outward bowing of the legs may occur. At this stage, limping begins, and it becomes difficult to meet daily needs independently.

Diagnosis: How Is It Diagnosed at the Hospital?

When you visit the hospital complaining of knee pain, an orthopedics specialist first performs a detailed physical examination. Swelling in the knee, range of motion, stability of the ligaments, and the points where pain is concentrated are checked manually. Your gait and leg alignment are observed.

The gold standard method for a definitive diagnosis is a two-way knee X-ray taken while standing and bearing weight. The narrowing in the joint space, the degree of cartilage loss, and new bone spurs forming at the bone edges are clearly seen on X-ray films. In most osteoarthritis cases, an X-ray is sufficient for diagnosis. However, if your doctor suspects an accompanying meniscus tear, ligament injury, or bone marrow edema, they may request a Magnetic Resonance Imaging (MRI) scan to examine the soft tissues better. In cases where rheumatic diseases are suspected, laboratory tests measuring inflammation values in the blood are utilized.

Knee Osteoarthritis Treatment: PRP and Hyaluronic Acid Applications to the Knee

Knee osteoarthritis treatment is personalized according to the stage of the disease and the patient's lifestyle. The first step of treatment is always lifestyle changes. Losing weight is the most effective way to reduce the load on the knee. Ice compresses applied at home and exercises that strengthen the muscles around the knee play a major role in pain control.

In non-surgical hospital treatments, intra-articular injections stand out. Hyaluronic acid application aims to replace the lubricating fluid the knee has lost. This fluid acts almost like a shock absorber by reducing the friction of the bones against each other. It is usually administered in one to three sessions, once a week, and its effect lasts between six months and a year.

PRP treatment for the knee is a biological repair method. A small amount of blood taken from the patient's arm is centrifuged in special devices to separate the part rich in healing cells. This valuable plasma obtained is injected into the knee joint during the same session. Growth factors secreted by platelets initiate the healing process in the damaged cartilage tissue. PRP is generally applied in two or three sessions, with an interval of two or three weeks.

Injection procedures are performed in outpatient clinic conditions, and the patient can walk home the same day. Resting the knee and avoiding heavy activities for the first 24-48 hours after the procedure is recommended. The full effect of the treatment is usually felt within a few weeks.

Complications and Risk Groups in Untreated Osteoarthritis

When osteoarthritis symptoms are ignored, cartilage destruction accelerates and reaches an irreversible point. When the joint space is completely closed, bones rub against each other, leading to serious bone cysts and deformities. This situation can take away the patient's freedom of movement, causing them to become housebound.

Inactivity brings weight gain, creating a vicious circle that worsens osteoarthritis even further. Especially in the elderly age group, falls become more frequent due to weakness and loss of balance in the knee. This situation paves the way for serious life-threatening risks, bringing up the issue of fall risk in advanced age and prevention of hip fractures. For patients who have reached an advanced stage and cannot benefit from injections or physical therapy, the only permanent solution is knee replacement surgery. Obesity patients, diabetic individuals, and those with rheumatic diseases are among the high-risk groups where osteoarthritis progresses faster.

When to See a Doctor? (Emergencies)

When knee pain starts to restrict your daily life, you should definitely see an orthopedics specialist. Especially if you wake up from sleep at night due to pain, if there is constant swelling in your knee, and if you cannot walk without limping, you should seek medical support without wasting time.

Some situations require emergency intervention. If you experience the following symptoms, you should immediately apply to the nearest emergency department or call the 112 Emergency Assistance line:

• Sudden and severe pain that completely prevents bearing weight on the knee.
• Deformities in the knee after a fall, impact, or traffic accident.
• Sudden redness, excessive heat, throbbing pain, and accompanying high fever in the knee following any injection treatment to the knee.
• Sudden loss of sensation, tingling, or bruising developing in the leg.

The Process and Our Orthopedics Approach at BHT CLINIC

At the BHT CLINIC İstanbul Tema Hastanesi Orthopedics and Traumatology Department, up-to-date and scientific treatment protocols are applied for our patients presenting with knee osteoarthritis complaints. Our expert physician staff meticulously evaluates the stage of the osteoarthritis and plans the most suitable PRP, hyaluronic acid, or other non-surgical options for you.

When coming to our hospital, bringing your old X-ray, MRI results, and a list of the medications you use will speed up the diagnostic process. In cases of emergency trauma or unbearable pain, our 24/7 emergency department and on-duty teams offer uninterrupted medical support. In advanced stage cases requiring surgical intervention, knee replacement operations are safely performed with our modern operating room equipment.

Frequently Asked Questions

How long does PRP treatment for the knee take?

The process of drawing blood, separating it in the centrifuge device, and injecting it into the knee takes approximately 30-40 minutes in total. The procedure is completed quite quickly in an outpatient setting.

Is intra-articular injection treatment painful?

The pain felt during the injection is no different from a standard blood draw. When necessary, local cooling sprays are used before the procedure to ensure the patient's comfort.

Does knee osteoarthritis and fluid loss go away completely?

Osteoarthritis is a chronic process, and there is no treatment that completely restores the cartilage to its former youthful state. However, with treatments like PRP and hyaluronic acid, pain is brought under control, the progression of the disease is slowed down, and the quality of life is significantly improved.

Can PRP and hyaluronic acid be done at the same time?

Depending on your physician's evaluation, in some cases, these two treatments can be combined or planned as sequential sessions. Since the mechanism of action of both methods is different, they can support each other.

Can I walk immediately after the injection treatment?

Yes, you can leave the hospital walking immediately after the injection procedure. However, for the first few days, it is recommended to avoid long walks that will strain your knee, going up and down stairs, and heavy sports.

To book an appointment and consult with our specialist physicians, you can visit our appointment page or contact us via our call center at 0850 811 34 00.

This article is for informational purposes only; please be sure to consult your physician for diagnosis and treatment.