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- Talk
- Canada
AAC/CAS/COA Position Statement on Intra-articular Joint Injections
Description
This summary outlines a presentation by Dr. Brendan Sheehan on the Joint Position Statement regarding intra-articular injections for knee arthritis, published in July 2019. The collaboration involves expert insights from the Canadian Orthopaedic Association, the Canadian Arthroplasty Society, and the Arthroscopy Association of Canada. The presentation discusses five key recommendations regarding injections used for knee arthritis treatment, including corticosteroids, hyaluronic acid, PRP (platelet-rich plasma), and stem cell injections.
Dr. Sheehan emphasizes the effectiveness of corticosteroid injections for short-term pain relief and the benefits of high molecular weight hyaluronic acid. However, he notes insufficient evidence for other combinations and conflicting results regarding PRP injections. He outlines safety concerns related to repeated corticosteroid injections, citing a study that raises questions about potential cartilage loss.
High molecular weight agents and cross-linked hyaluronic acid show superior outcomes compared to their lower weight and non-cross-linked counterparts, demonstrating considerable efficacy in reducing pain. However, the evidence analyzing the combination of hyaluronic acid with corticosteroid injections is limited and often heterogeneous.
Dr. Sheehan warns that while PRP offers a promising but variable approach, more studies are needed to confirm its effectiveness. He also concludes that cell-based therapies necessitate further rigorous research before routine clinical application. Final recommendations stress that injections currently benefit primarily those with mild to moderate knee osteoarthritis, with corticosteroid injections providing short-term relief and hyaluronic acid yielding prolonged benefits.