2. Corticosteroid Injections
Examples: Triamcinolone, Methylprednisolone
Mechanism: Strong anti-inflammatory agents that suppress local cytokine release (like IL-1β, TNF-α) when injected into the joint.
Benefits:
- Rapid and significant short-term pain relief
- Useful during acute flare-ups of synovitis
Risks/Limitations:
- Relief lasts only a few weeks to a few months
- Repeated use accelerates cartilage degradation
- Suppresses natural tissue repair response
- Potential for joint infection (septic arthritis)
3. Hyaluronic Acid (HA) Injections (Viscosupplementation)
Examples: Triamcinolone, Methylprednisolone
Mechanism: HA is a natural component of synovial fluid. Injected HA aims to restore lubrication and shock absorption in the joint.
Benefits:
- Modest improvement in pain and mobility (varies by individual)
- Helps some patients avoid NSAIDs temporarily
Risks/Limitations:
- Effect is often minimal and slow to onset (weeks)
- No impact on inflammatory cytokines or cartilage degradation
- Expensive and not effective for everyone
- Multiple injections required
4. Joint Replacement Surgery (Total Knee Arthroplasty or Hip Replacement)
Procedure:Damaged joint surfaces are surgically removed and replaced with artificial components (metal, ceramic, plastic).
Benefits:
- For end-stage OA, it may provide significant relief and mobility improvement
- Best suited for severe, debilitating OA when all else fails
Risks/Limitations:
- Major surgery, expensive, risk of infection, clotting, or implant failure
- Not a cure: does not address the inflammatory environment or metabolic imbalances
- Lifespan of the implant is limited (~15–20 years)
- Often followed by long and painful rehabilitation
