Relief without surgery

Are injections right for you?

Hip and knee osteoarthritis often responds well to a stepwise, non-surgical plan long before replacement is on the table. Injection therapies sit alongside activity modification, weight management, physical therapy, and oral medications, and they can be the difference between living with daily pain and staying active on your own terms.

The right injection depends on your joint, the stage of your arthritis, your goals, and what your insurance covers. Below is an honest, evidence-based look at the three therapies we offer most often, what each does, how strong the evidence is, and how long relief tends to last.

Cortisone (corticosteroid) injections

A corticosteroid is a potent anti-inflammatory. Injected directly into the joint, it quiets the inflammation that drives arthritis pain and swelling. It is the most predictable, fastest-acting option we offer.

Cortisone is most useful for a painful flare or when you need reliable relief for a defined window, an upcoming trip, an event, or to get through a course of physical therapy. Response varies: some patients get months of relief, others a few weeks.

• We generally space injections no closer than 3 months apart and limit how many a joint receives per year.
• Repeated, frequent cortisone may, over time, have effects on cartilage, so we use it thoughtfully rather than on a fixed schedule.
• Diabetic patients may see a temporary rise in blood sugar for a few days afterward.
• A short-lived "steroid flare", increased ache for a day or two before relief sets in, is common and harmless.

Hyaluronic acid (viscosupplementation)

Hyaluronic acid (HA) is a substance your joint already produces to lubricate and cushion the cartilage surfaces. In arthritis it thins out. Viscosupplementation replaces it, supplementing the joint fluid to improve glide and dampen pain. It is FDA-approved for the knee; use in the hip is off-label but performed under imaging by experienced providers.

Unlike cortisone, HA works gradually, relief builds over several weeks rather than days, but can last longer for the right patient. Depending on the product, it is given as a single injection or a short weekly series.

• Best suited to mild-to-moderate knee arthritis in patients who want to avoid or limit steroids.
• The evidence is genuinely mixed, professional guidelines vary, and not every patient benefits. We will give you a straightforward assessment of whether you are a reasonable candidate.
• A useful option when cortisone gives only brief relief, or for patients managing diabetes who prefer to avoid steroid effects on blood sugar.
• Coverage varies by insurer and is usually approved for the knee, not the hip.

PRP (platelet-rich plasma)

PRP is a biologic, or "orthobiologic", therapy made from your own blood. We draw a small sample, spin it in a centrifuge to concentrate the platelets and their growth factors, and inject that concentrate into the joint. The idea is to use your body's own healing signals to calm inflammation and create a healthier environment inside the joint, rather than simply mask the pain.

For mild-to-moderate knee osteoarthritis, a growing number of high-quality studies show PRP can ease pain and improve how the joint moves, and in several of them it worked better than hyaluronic acid at 6 to 12 months. Since PRP is made from your own blood, the risk of a reaction is very low.

• Most appropriate for earlier-stage arthritis in active patients looking to delay surgery.
• Evidence is strongest in the knee and still developing for the hip; preparation methods are not yet standardized across the field.
• PRP is generally not covered by insurance and is an out-of-pocket cost, we will review pricing transparently before you commit.
• Briefly stopping anti-inflammatory medications (such as ibuprofen) around the injection is sometimes advised; our office will provide you with specific instructions.

Why ultrasound guidance?

Every injection in our office is placed under real-time ultrasound guidance. Instead of relying on surface landmarks, we watch the needle reach its precise target and confirm the medication is delivered exactly where it belongs, inside the joint.

• Accuracy: Image guidance markedly improves the odds the medication lands intra-articularly, which directly affects how well it works, this matters most in the hip, a deep joint that is unreliable to inject blind.
• Safety: Seeing vessels and nerves in real time helps us avoid them.
• Comfort: A confident, single, accurate pass is more comfortable than repeated repositioning.
• No radiation: Ultrasound is performed at the bedside with no radiation exposure, unlike fluoroscopy.

What to expect

The visit

After we review your history, exam, and imaging, the skin is cleaned and numbed. Using ultrasound, the injection is placed, the entire procedure usually takes only a few minutes. PRP visits run a little longer because of the blood draw and preparation step.

Afterward

• Expect mild soreness at the site for a day or two; ice and acetaminophen help.
• Take it easy on the joint for the rest of the day, then resume normal activity as comfort allows.
• Cortisone tends to work within days; HA and PRP build over weeks, patience is part of the plan.
• We will schedule a follow-up to measure your response and decide on next steps.

Choosing a therapy together

There is no single right answer, the best option depends on your joint, your arthritis, your goals, and your coverage. As a general framework:

• Need reliable relief soon, or managing a flare? Cortisone is usually the starting point.
• Mild-to-moderate knee arthritis, want to limit steroids? Hyaluronic acid is worth discussing.
• Earlier-stage arthritis, active, aiming to delay surgery? PRP may be the most forward-looking option.

Kyle and Dr. Debbi will walk through the trade-offs with you and build a plan, often combining injections with physical therapy and activity changes for the best, longest-lasting result.