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What to Expect: Joint and bursa injections are reserved for individuals that have often failed other conservative therapies, or may not be able to start therapy secondary to pain and inflammation. Often times, a steroid medication such as triamcinalone or dexamethasone is injected into a joint or bursa with a local anesthetic to help reduce pain and inflammation to help an individual return to a therpay program. Viscosupplementation (VS) is a treatment offered to help patients with knee arthritis. Typically, the injections span three weeks, with the patient receiving one injection into the affected knee per week. Both knees can be injected on the same day. The FDA has only approved this treatment for knee arthritis, but data seems to be pointing towards success with injecting other joints, as well. Dr. Davis can help decide if VS indicated for a patient with knee arthritis or arthritis in other joints. As VS is only approved by the FDA for knee injection, other joint injections will usually not be covered by insurance. Pre-procedure: After obtaining informed consent - the patient is explained the procedure in detail and ALL questions answered, the area to be injected is cleaned with betadine, alcohol or both. A cold spray is used to numb the skin surface (as opposed to injecting the skin with a topical anesthetic). Sterile gloves are donned and the injection proceeds. Each joint has its own difficulty level based on the size of the joint, the degree of deformity of the joint and the size and relaxation of the patient. Most injections can be performed with minimal discomfort and often are completed in less than one minute. Post- procedure: Patients are sent home with a list of instructions what to be on the look-out for. All injections have a risk of infection, local bleeding, allergic reaction and lack of improvement. Steroids injected into joints slightly increase risk of developing arthritis (if not already present) and when injected near muscle have a slight risk of leading to muscle weakness or tear. Patients with diabetes are at higher risks for all complications, and can lose control of their blood sugars for up to one week. These should be monitored closely after injection. In rare instances, injections done near the skin can cause loss of the fat tissue or the skin color. Patients should inform the physician or a local urgent/ emergent care center if any serious reaction is noted. |
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