Knee pain and stiffness can be debilitating and difficult to treat. Lifestyle-limiting knee conditions may negatively affect body image and emotional well-being. Weight management, exercises/strengthening programs, physical therapy, physical modalities, orthotics, medications, intra-articular knee injections, and surgery are some of the approaches used to treat knee pain. The most common type of intra-articular knee injection is with corticosteroids, but other agents have been used, including infliximab, hyaluronic acid, botulinum neurotoxin, and platelet-rich plasma (PRP) BUT what are the contraindications?
@drisana Intra-articular steroid knee injections are contraindicated in patients with bacteremia, sepsis, periarticular or intra-articular infections (eg, septic arthritis, periarticular cellulitis, and osteomyelitis), significant skin breakdown at the target site, known hypersensitivity to the steroid injection, intraarticular or osteochondral fracture at the target site, severe joint destruction, joint prosthesis, or uncontrolled coagulopathy.
Absolute contraindications for PRP knee injections include the following:
Hemodynamic instability or septicemia
Septic arthritis, overlying cellulitis, or adjacent osteomyelitis
Platelet dysfunction syndrome
Relative contraindications to PRP knee injections include the following:
Regular nonsteroidal anti-inflammatory drug (NSAID) use within 48 hours of the procedure
Corticosteroid injection of the knee within 1 month or systemic corticosteroid use within 2 weeks
Recent fever or illness
Cancer, particularly of bone or blood
Anemia, with a hemoglobin level lower than 10 g/dL
Thrombocytopenia, with a platelet count lower than 10 5/μL