If you suffer from osteoarthritis in your Knee, Ankle or Hands; chances are you’ve been offered injections to manage your symptoms. These have the advantage of being less invasive and minimal risk (very minor risk of infection, or reaction to drug/product).
There are three main flavours of injection:
- Cortisone/Steroidal anti-inflammatory
- PRP injection (Platelet Rich Plasma)
- Stem Cell injection
The question is, which one is best?
Corticosteroids have been used to decades to manage acute flare up in inflammatory joint conditions, and are moderately successful at reducing pain for 2-12 weeks. They do not change the disease process, and at best will allow some return to normal function, rehabilitation, and lifestyle. On the down side, they have a tendency to weaken collagen fibre for a short period after injection, resulting in higher chance of soft tissue rupture (if the joint is overloaded due to high level activity once the pain is gone).
PRP injection is relatively new on the scene, so no real long term studies have been done to demonstrate the effectiveness but essentially the treatment relies on the healing products of your own blood to help lay down some “cartilage scar”. Normally treatment involves three injections over three weeks, and then another a month after. Initial results are only moderately promising for relief of pain in mildly arthritic knees and joints, but more advanced arthritis does not respond, as the cartilage is too far gone already. More research needs to be done here, but at this stage it is not very positive when compared to placebo injection.
Stem cells are the miracle panacaea for the body, because they can be instructed to turn into any type of cell that we like. In theory a simple injection of stem cells (which we can harvest from the patients own skin or blood cells) with the appropriate growth factors, and Viola! Your cartilage is restored. Unfortunately, this is not reality. Yet. Leading specialists agree that we don’t yet have to technology to tell the cells WHERE to bond in the damaged tissue, and would require surgical implantation of a biological lattice/matrix first. In the future this may be possible, but at this stage the evidence points towards it being a $10,000 waste of your money.