Knee Injections
SPOC offers a range of injections for controlling pain and inflammation in the knee to improve function. Dr Damasena may recommend one of these injections in addition to other non-operative treatment such as physiotherapy, hydrotherapy, bracing, and weight loss.
Viscosupplementation (HA) Injections
Cingal Injection (HA + Steroid)®
When you have osteoarthritis, there may not be enough natural hyaluronic acid in the joint, and the quality of that hyaluronic acid may be poorer than normal.
Cingal® is given in a single shot (injection) directly into the knee joint. The injection of Cingal® supplements (adds) hyaluronic acid into the knee joint. The corticosteroid contained in Cingal® quickly reduces inflammation to provide fast relief, while the hyaluronic acid cushions the knee joint to provide long-lasting relief.
Cost: $690 single injection (Medicare rebate available).
Monovisc (HA)®
Monovisc® is a single-injection viscosupplement for long-lasting relief of osteoarthritis knee pain. Monovisc® supplements the hyaluronic acid naturally found in a healthy knee with ultra-pure, non-avian hyaluronic acid.
Cost: $590 single injection (Medicare rebate available)
FREQUENTLY ASKED QUESTIONS
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The effects seem to differ widely for patients. Some notice pain and function improvement within days, others take several weeks, and some people receive no benefit at all. Those who do get pain relief usually report it lasting from 6-12 months, after which re-injection is an option.
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Some people may notice a reaction close to the injection site, such as pain, redness, warmth, slight swelling or stiffness, immediately after the injection. These symptoms generally do not last longer than 48 hours. We recommend applying an ice pack to the knee and taking some simple pain relief to ease the discomfort.
Occasionally, people report a headache, muscle pain, nausea, sore throat and flu-like symptoms. If these occur and do not resolve within 24 hours, we recommend you consult your doctor.
There are some rare side effects that are more serious, and if experienced you should contact your doctor immediately. They include:
allergy – rashes, hives, itching, flushing and swelling of the face, tongue or throat, chest tightness and shortness of breath
severe inflammation of the joint, a large increase in pain and swelling in your knee, or your knee becomes red and hot. These signs may indicate an infection in the joint, which can be serious, especially if left untreated.
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The injection process itself only lasts a few minutes.
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Yes, you can drive immediately after your injection.
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You may return to work and your normal day-to-day activities immediately after the injection.
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You should refrain from heavy lifting and strenuous activities for 24–48 hours or until symptoms from the injection have subsided.
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Some people experience some pain or dscomfort for 24-72 hours after the injection. Usually this subsides. We recommend you ice the knee and take over the counter anti-inflammatories. Should your symptoms not improve as above please consult your Surgeon.
NSTRIDE® AUTOLOGOUS PROTEIN SOLUTION
nSTRIDE is an autologous protein solution (APS) containing anti-inflammatory cytokines and anabolic growth factors.
It is one of the latest biologic regenerative treatments used in treating knee osteoarthritis.
As an autologous solution, it is obtained by separating white blood cells and platelets from your blood and concentrating them in a small volume of plasma, using the APS kit.
The obtained APS is then injected directly into the osteoarthritic knee joint.
Cost: This varies depending on your HealthFund and if the injection is completed in the operating theatre or in the rooms.
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In osteoarthritis of the knee, inflammatory cytokines (bad proteins) are in higher concentrations than anti-inflammatory cytokines (good proteins). This imbalance leads to inflammation and gradual degeneration of the knee cartilage.
nSTRIDE APS contains concentrated anti-inflammatory cytokines, which inhibit the activity of inflammatory cytokines in the osteoarthritic knee. This reduces inflammation and slows down or halts the degeneration of the knee cartilage.
nSTRIDE is also rich in anabolic cytokines, which stimulate the synthesis of the cartilage matrix.
Reducing inflammation and stimulating repair of the damaged cartilage tissue helps slow down or reverse the progression of osteoarthritis. Note that although nSTRIDE was initially indicated for treating knee osteoarthritis only, the manufacturer is now approving its use to treat osteoarthritis in other joint
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Compared to traditional osteoarthritis treatment methods, nSTRIDE has many benefits.
These include:
It is a non-invasive procedure involving a single injection.
Significantly reduces inflammation and pain (70% reduction) associated with knee arthritis for up to two years.
Significantly improves mobility in the treated knee.
Protects cartilage from catabolic degeneration
Promotes cartilage cell proliferation
It is an autologous treatment, which eliminates the risk of adverse reactions.
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nSTRIDE injection is used to relieve the symptoms of mild to moderate knee osteoarthritis. Patients with severe osteoarthritis cannot benefit from this treatment as their knee cartilages are almost, if not entirely, degenerated.
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During the procedure, our specialist draws blood from your arm and separates it to obtain a concentrated nSTRIDE APS solution. This solution (about 3ml) is then injected into the osteoarthritic knee. During injection, you may experience a minor pinch and discomfort.
After the treatment, it’s normal to experience some knee pain and stiffness, which subsides after about 2 days. After the treatment, one should minimize physical activities for the next 14 days to increase the efficacy of the APS injection. Osteoarthritis pain starts to decrease in approximately one to two weeks following the nSTRIDE injection. After a few weeks, pain and discomfort are alleviated, and the attained results last for approximately 12-24 months. Although this treatment is one of the best in the industry, it is still not a cure for osteoarthritis.