Osteoarthritis (OA) is a chronic disease that develops when the cartilage that protects and cushions the ends of the bones and cushions the ends of the bones begins to wear down due to various factors, such as aging factors, such as aging, repetitive injuries, mechanical overload, among others, among others. This wear and tear alters the structure of the joint, which triggers inflammatory processes and inflammatory processes and progressive deterioration of the tissue.
OA can cause disability and is one of the most common disorders in the population, with a frequency of 30% in people aged 45 to 60 years, and a higher frequency of 80% in people aged 80 years. This occurs when the dynamic balance between tissue injury and repair is disrupted. Damage to cartilage causes bones to rub directly against each other, generating friction, pain, inflammation, and stiffness, especially when moving and in more severe cases, at rest.
The mobile parts of the joint are the first to suffer, as there is a progressive loss of bone in the articular cartilage, making it rough and eroding it little by little. In most cases, due to the relationship between the articular cartilage and the synovial membrane, OA affects the joint as a whole.
This is a very common problem, very disabling and reluctant to treatment, because, once the process of joint wear begins, nothing stops it, and it is a matter of time before it progresses to the point of requiring surgery. However, there are conservative treatments that allow prolonging this procedure. We speak then of physical therapies and infiltrations with anti-inflammatory drugs, hyaluronic acid and biological therapies such as platelet-rich plasma. Each of these has its own specific indications, as it may be useful for some patients and not for others. Let me explain:
Infiltrations with corticosteroids or cortisone
This type of infiltration is very effective for very short-term pain relief. They are usually applied with anesthesia to minimize discomfort when they take effect. Another important reason to combine it is to confirm that the medication is in the injured tissue. Subsequently, an evaluation visit is required after two weeks. It should be noted that this type of infiltration is not recommended more than three times in a year.
To perform the procedure it is necessary to pause the intake of anticoagulant medications or supplements with anticoagulant effect to avoid bruising or bleeding. During the application, the knee area is cleaned and with the help of an ultrasound scanner, the advancement of the needle in the knee can be visualized for greater precision. Some people have redness and a feeling of warmth in the chest and face. It is normal to experience knee pain and swelling during the first 24 to 48 hours. Relative rest is recommended.
Infiltrations with platelet-rich plasma (PRP)
Plasma is a natural component of blood, rich in proteins, among other properties. While platelet-rich plasma is a concentrate with a higher number of platelets than those usually found in the blood. Among its properties are the platelet growth factors, which are indispensable for injuries to heal properly.
In order to carry out the infiltration, the patient's blood must first be drawn and centrifuged. This process allows the isolation of the PRP, which may contain 3 to 5 times more platelets than normal. Often these platelets are activated by means of substances such as thrombin, calcium chloride, calcium gluconate, which stimulates the growth factors essential for tissue regeneration. Finally, plasma reinjection is performed, which is carried out with the aid of an ultrasound scanner to precisely locate the lesion.
In the case of this infiltration, anesthesia cannot be applied previously, since it modifies the structure and function of the substance, which would make it less effective. Relative rest is recommended once applied.
Infiltrations with hyaluronic acid
Hyaluronic acid is a natural substance found in the synovial fluid of the joints, providing lubrication and cushioning. However, joint conditions such as osteoarthritis lead to a decrease in this substance and consequently to wear, friction and pain.
Hyaluronic acid injections restore joint lubrication, reducing friction and inflammation. As with platelet-rich infiltrations, these are applied without anesthesia to avoid modifying the substance and its effect.
I invite you to read more about this procedure in detail on my blog: https://mongeortopedia.com/en/blogs/infiltraciones-en-la-rodilla-con-acido-hialuronico-para-tratamiento-de-artrosis-de-rodilla/
During your visit with your trusted orthopedic surgeon, multiple aspects are evaluated to diagnose and, above all, recommend the most appropriate treatment. If you are looking to postpone surgery, there is always the option of a multidisciplinary conservative treatment. This includes orthopedic aids such as canes, crutches, walkers, bandages, therapy with a physiotherapist, as well as nutritional assistance that provides the patient with a balanced and nutritious diet. If necessary, a specific diet is recommended to reduce the load on the joints. All this should be accompanied by rigorous follow-up consultations.
It should be emphasized that this type of infiltration does not cure osteoarthritis, but reduces pain and inflammation sufficiently so that the body can continue its work of healing or cope with it with less discomfort.Each patient is unique, and not necessarily knee pain is a sign of a condition or osteoarthritis and not all patients are candidates. Therefore, a detailed and individualized diagnosis is essential.
