Knee Injection vs. Knee Replacement: Which Is Best for Chronic Knee Pain?
Treatment depends on severity of pain and damage
Treatment depends on severity of pain and damage
Key Takeaways
- Knee injections can reduce pain and improve mobility.
- Cortisone, HA and PRP injections work in different ways.
- Knee replacement may help when pain is severe.
- Treatment depends on symptoms and joint damage.
Knee pain can make everyday activities — from walking and climbing stairs to exercising and getting a good night’s sleep — difficult and frustrating.
If you’re living with chronic knee pain, you may have already tried treatments, such as over-the-counter pain medicine, physical therapy, knee braces or lifestyle changes, without enough relief.
You may also be wondering whether knee injections or knee replacement surgery could help provide longer-lasting pain relief, improve mobility and help you get back to the activities you enjoy.
“Chronic knee pain can have many causes, including arthritis, previous injuries and wear and tear in the joint over time,” says Jeffrey Wilde, MD, an orthopedic surgeon at Scripps Clinic Torrey Pines and Scripps Clinic Mission Valley. “The best treatment depends on the cause of the pain, the severity of symptoms and how much it’s affecting your daily activities and mobility.”
How common is chronic knee pain?
Chronic knee pain affects about 1 in 4 Americans and is most often caused by osteoarthritis, a condition in which cartilage in the knee gradually wears away. As cartilage breaks down, bones can rub together, leading to pain, swelling and reduced mobility. Doctors often use X-rays to help diagnose knee osteoarthritis and assess the severity of joint damage.
Symptoms of chronic knee pain
Symptoms can range from mild discomfort to severe pain that interferes with walking, exercise and other daily activities.
Some of the most common symptoms of chronic knee pain may include:
- Knee instability
- Knee buckling or giving out
- Sharp knee pain
- Burning or aching pain around the knee
- Swelling and stiffness
- Trouble straightening the knee
- Warmth around the knee
- Popping, crunching or clicking sounds
- Knee pain at night
Although knee osteoarthritis is more common in older adults, it can also affect younger people. This is especially true for those with a previous knee injury.
Types of knee injections for pain
When medications and physical therapy no longer provide enough relief, your doctor may recommend knee injections to help reduce pain and improve mobility. Different injections work in different ways.
“Several types of injections are available and the best option depends on the severity of your arthritis, your symptoms and your overall health,” Dr. Wilde says.
Side effects are not common but may include temporary pain or swelling at the injection site and, rarely, infection.
Corticosteroids (cortisone injections)
Corticosteroid injections for knee pain are often the first injectable treatment to help reduce inflammation and relieve knee pain. Relief often starts within a few days and may last for several weeks or a few months.
Because repeated cortisone injections may increase the risk of cartilage damage over time, doctors typically limit how often they are used. Cortisone injections are usually covered by insurance.
Hyaluronic acid injections
Hyaluronic acid (HA), often called gel injections, helps lubricate and cushion the knee joint. Osteoarthritis can reduce this fluid over time. HA injections may improve pain and mobility for some patients.
Treatment may involve one injection or a series given over several weeks, with relief sometimes lasting up to six months. Gel injections are generally considered low risk and may be covered by insurance.
Platelet-rich plasma (PRP) injections
PRP is a regenerative treatment that uses components of your own blood to help reduce joint inflammation and relieve joint pain.
During the procedure, a sample of blood is drawn and processed to concentrate platelets and growth factors. The platelet-rich plasma is then injected into the knee joint.
Research suggests PRP injections may help reduce pain and improve function in some people with mild to moderate knee osteoarthritis, though results can vary and more research is needed. Insurance coverage is often limited.
Knee injection vs. knee replacement: Which treatment is right for you?
Knee injections can ease arthritis pain and may help delay surgery. A knee replacement may be recommended when other treatments no longer provide enough relief.
What happens during knee replacement surgery?
During knee replacement surgery, damaged cartilage and bone are removed and replaced with metal and plastic implants designed to relieve pain and improve mobility. Depending on the extent of the arthritis, patients may need a partial or total knee replacement.
Many knee replacements now use minimally invasive or robotic-assisted techniques to improve surgical precision and support faster recovery.
Surgery usually takes one to two hours. Many patients go home the same day while some stay one night in the hospital. Physical therapy begins soon after surgery to regain strength and range of motion. Most people can return to many normal daily activities within a few weeks. Full recovery may take up to a year.
Risks of knee replacement
Knee replacement is generally safe, but like any surgery, it carries some risks. These can include infection, blood clots, stiffness and implant wear over time. In some cases, you may need revision surgery in the future.
How long do knee injections and knee replacements last?
Knee injections can provide short-term pain relief that may last several months. Results vary by injection type and arthritis severity.
Knee replacement surgery can provide long-term pain relief and improved mobility for many years. Many patients experience significant improvements in daily activities, independence and overall quality of life after surgery.
Knee specialists at Scripps
Scripps is a recognized national leader in knee replacement surgery. U.S. News & World Report consistently ranks Scripps as one of the nation’s best programs for orthopedics and orthopedic surgery.
Watch the video on treatments for knee pain
Watch the San Diego Health video with host Susan Taylor and Dr. Wilde discussing treatments for knee pain.