Injection Therapies for Osteoarthritis

Those suffering from knee and hip pain due to osteoarthritis should know that there are some emerging technologies that may offer significant pain reduction and increased function. The hope is that one day, these technologies may actually all but eliminate the need for joint replacement procedures. These new procedures use injections that either replace diminished joint fluid or stimulate the body’s own nature ability to heal so that the degeneration of the tissue is either halted or reversed. There are several different types of injection therapies which I would like to explain.

The first procedure is a hyaluronic acid injection. This is a synthetic synovial fluid. Synovial fluid is naturally produced in joints like the knee and hip. It is a fluid that baths the joint, lubricating it, helping to provide nutrition to the cells and aids in shock absorption. With degenerative arthritic conditions this fluid production is slowed and there isn’t as much synovial fluid as when the joint was healthier. Synthetic forms of this fluid have been engineered and may be injected directly into the affected joint. There have been reports of good results in both the reduction of pain and an increase in function lasting from a few months to even upwards of a year. This is a procedure that is fairly readily available in Canada but as of yet, many people don’t know about it. It is not usually covered by government health plans (OHIP) but may be covered by some private insurance.

PRP injections are a different type of injectable therapy. PRP stands for Platelet Rich Plasma. Platelets are blood cells that are involved in the clotting and healing process. In this procedure the patient’s own blood is taken, it is then spun in a centrifuge to concentrate the platelet cells and then is injected back into the affected joint. Platelet cells contain growth factors which are chemicals that stimulate the body to heal. The theory is that by concentrating these factors and introducing them into a deteriorating joint that the healing process will “catch-up” and overtake the deterioration process resulting in a healthier joint. I understand that this procedure is an emerging procedure in Canada but it is not commonly performed as of yet and it may be difficult to find a doctor that does the procedure. Again, it is not usually covered by government insurance and probably isn’t usually covered even under private insurance.

By now, most people have heard about stem cell therapy. These types of therapy are being heralded as a potentially amazing therapy for everything from cancer treatment to, in our case, arthritis treatment for the joints. When stem cells are injected into damaged tissue, it is believed that they can start a healing process and actually regenerate tissues such as connective tissue, including ligaments and tendons and perhaps even hair and skin. Although the number of stem cells we have in our bodies decreases with age we do have sites that are “storage” areas that are rich in stem cells. These cells can be harvested from these locations, treated and then injected back into the degenerating joint. It is hoped that this process may become advanced enough in future years that it may one day actually eliminate the need for joint replacement procedures. This type of therapy is still in its infancy and although very promising may not be any more effective and is potentially not as effective as the previous two therapies mentioned at this time.  If available in Canada, it is extremely limited and is not covered through government or private insurance.

These therapies all hold promise for those suffering from pain and disability due to osteoarthritis of the hip and knee. They may be available with limited access in Canada but are readily available south of the border in the US. Synthetic synovial fluid injections costs approximately $750.00 dollars while PRP and stem cell treatments cost in the range of $2000.00 to $5000.00. Some private US insurance companies are beginning to cover these treatments but as of yet most private insurance in Canada does not.