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<p>Following the diagnosis of early osteoarthritis, which is accompanied by gonalgia, signs of osteoarthritis in the X‑ray diagnostics and changes in the cartilage and/or meniscus degeneration, there is a&#xa0;controversial debate about intra-articular joint injections. The indications for such interventions should be thoroughly evaluated and patients must be informed about the potential risks, such as septic arthritis or progression of osteoarthritis. Approved preparations, such as corticosteroids exhibit anti-inflammatory and immunomodulatory effects. The Osteoarthritis Research Society International (OARSI) issued a&#xa0;conditional recommendation for intra-articular injection in cases of osteoarthritis of the knee for acute and short-term pain relief in 2019. Extensive discussions have also been conducted regarding the injection of hyaluronic acid. Several studies described a short-term pain relief and improved function of the knee joint following injection, with a&#xa0;low risk of side effects, thus leading to a&#xa0;similar conditional recommendation from the OARSI. In recent years discussions surrounding platelet-rich plasma (PRP) have become increasingly more prominent, which is obtained from the patient’s blood by centrifugation. According to the consensus reached by the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) and the International Cartilage Research Society (ICRS), as of 2024 the injection of PRP is recommended for patients under 80&#xa0;years of age with osteoarthritis of the knee at Kellgren-Lawrence stages&#xa0;0–III after conservative treatment has proven ineffective, with an evidence level of grade&#xa0;I. Currently, intra-articular injections of alternative preparations, such as ozone, mesenchymal stem cells or cytokine inhibitors are not recommended due to insufficient data or lack of proven clinical efficacy. Regarding the management of athletes, it is essential to adhere to the antidoping regulations set by the World Anti-Doping Agency (WADA).</p>

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Injektionstherapie bei Früharthrose

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月4日

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  • Caroline Voigt,
  • Thomas Tischer,
  • Sina Gräber,
  • Christoph Lutter,
  • Andrzej Jasina

摘要

Following the diagnosis of early osteoarthritis, which is accompanied by gonalgia, signs of osteoarthritis in the X‑ray diagnostics and changes in the cartilage and/or meniscus degeneration, there is a controversial debate about intra-articular joint injections. The indications for such interventions should be thoroughly evaluated and patients must be informed about the potential risks, such as septic arthritis or progression of osteoarthritis. Approved preparations, such as corticosteroids exhibit anti-inflammatory and immunomodulatory effects. The Osteoarthritis Research Society International (OARSI) issued a conditional recommendation for intra-articular injection in cases of osteoarthritis of the knee for acute and short-term pain relief in 2019. Extensive discussions have also been conducted regarding the injection of hyaluronic acid. Several studies described a short-term pain relief and improved function of the knee joint following injection, with a low risk of side effects, thus leading to a similar conditional recommendation from the OARSI. In recent years discussions surrounding platelet-rich plasma (PRP) have become increasingly more prominent, which is obtained from the patient’s blood by centrifugation. According to the consensus reached by the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) and the International Cartilage Research Society (ICRS), as of 2024 the injection of PRP is recommended for patients under 80 years of age with osteoarthritis of the knee at Kellgren-Lawrence stages 0–III after conservative treatment has proven ineffective, with an evidence level of grade I. Currently, intra-articular injections of alternative preparations, such as ozone, mesenchymal stem cells or cytokine inhibitors are not recommended due to insufficient data or lack of proven clinical efficacy. Regarding the management of athletes, it is essential to adhere to the antidoping regulations set by the World Anti-Doping Agency (WADA).