Non-Surgical Knee Injections as an Alternative to Surgery

For people with knee osteoarthritis (OA) who want to avoid knee replacement, injection therapy can offer temporary but meaningful pain relief and may help delay surgery.

Common Non-Surgical Injection Options

1. Corticosteroid (Cortisone) Injections

• How they work: Reduce inflammation inside the joint, easing pain and stiffness.
• Duration: Typically 8–24 weeks, often 8–16 weeks www.kneepaincentersofamerica.com.
• Pros: Fast relief, especially during flare-ups.
• Cons: Short-term benefit; repeated injections (more than 3–4 times/year) can accelerate cartilage loss and increase surgery risk www.jeffreypengmd.com.
• Best for: Acute pain episodes or before planned activities.

2. Hyaluronic Acid (Viscosupplementation) Injections

• How they work: Sodium hyaluronate restores joint lubrication, reducing friction and providing anti-inflammatory effects int.livhospital.com+1.
• Duration: Up to 6 months of relief for some patients int.livhospital.com.
• Pros: Natural substance, fewer long-term risks than steroids.
• Cons: Slower onset of relief; not a cure.
• Best for: Early to moderate OA, especially if inflammation is a key factor.

3. Platelet-Rich Plasma (PRP)

• How they work: Concentrated growth factors from the patient’s own blood may stimulate tissue repair.
• Evidence: Mixed; some studies show modest benefit, but long-term durability is uncertain www.jeffreypengmd.com.
• Best for: Active patients with early OA or sports-related injuries.

4. Emerging Cartilage-Regenerating Injections

• Stanford research: A drug targeting the 15-PGDH protein can stimulate existing cartilage cells to regenerate, potentially reversing damage without surgery or stem cells Futura.
• Status: In early human trials; not yet widely available.

When to Consider Injections vs. Surgery

• Injections: Often used in early to moderate OA or as a bridge to surgery. They can improve function and comfort but do not reverse structural damage.
• Surgery (e.g., total knee replacement):Recommended when conservative measures fail and joint damage is severe, with full recovery taking ~12 months www.kneepaincentersofamerica.com.

Key Takeaways

• Short-term relief: Corticosteroids are fastest but riskier with frequent use.
• Mid-term relief: Hyaluronic acid offers longer-lasting lubrication and anti-inflammatory effects.
• Regenerative potential: New therapies like 15-PGDH inhibitors may one day prevent or reverse cartilage loss.
• Best approach: Start with conservative care (physical therapy, weight management, activity modification), then consider injections if symptoms persist.

If you’re considering injections instead of surgery, discuss your OA stage, activity level, and goals with your orthopedic specialist to choose the safest and most effective option.