Yasmin Dhar, M.D.
Orthopedic Surgeon and Sports Medicine Specialist
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Ultrasound Guided Injections
Musculoskeletal ultrasound is used to help guide joint and tendon injections, such as pain or cortisone injections and platelet-rich plasma. The ultrasound machine is first used to identify the injury and evaluate surrounding areas. Then, the injection needle is introduced under the guidance of the ultrasound to maximize precision. Ultrasound guidance can improve the effectiveness and safety of many injections by helping isolate the injured or inflamed area as well as avoiding adjacent important structures such as nerves or blood vessels.
Platelet-rich plasma is a new non-operative treatment for sports injuries. It has shown success in treating persistent cases of a wide array of tendon and ligament injuries, such as tennis elbow, patellar tendinosis, Achilles tendinopathy, and knee ligament sprains.
The treatment for many musculoskeletal injuries is directed at reducing inflammation and sometime fails. These injuries are often the result of repetitive damage of tendons or ligaments, causing decreased blood-flow with degenerative changes in these areas. Platelet-rich plasma (PRP) is formed by spinning down your own whole blood to obtain concentrated growth factors and proteins, which, when injected into the damaged tissue, can help facilitate new growth of healthy tissue.
Injectable corticosteroid medications have been used to treat a variety of conditions, including tendonitis, arthritis, carpal tunnel and bursitis. Cortisone is naturally produced by the body when the body in under stress to decrease inflammation. Injectable cortisone can provide significant pain relief and help earlier return to sports by decreasing inflammation
Cortisone is not a “pain-reliever”; it works by decreasing the body’s reaction to inflammation. By lessening inflammation, pain can also be improved. Maximum effect may take a few days, but can last for weeks or even permanently. Cortisone injections should be used in combination with appropriate rehabilitation and rest period to gain the best results. Also, multiple injections to an area may decrease the body’s ability to heal, possibly leading to further injury in the future.
The first line of treatment for osteoarthritis of the knee aims to relieve pain. A relatively new procedure, called viscosupplementation, injects a preparation of hyaluronic acid, a naturally occurring substance found in normal joint fluid, into the knee joint. It acts as a lubricant for motion and as a shock absorber for joint loads. A less than normal concentration of hyaluronic acid is present in joints with osteoarthritis.
Viscosupplementation has been shown to relieve osteoarthritis pain in many patients who cannot obtain relief from other measures or analgesic medications. Although, hyaluronic acid does not have an immediate pain-relieving effect, the long-term results may last months. Viscosupplementation may be a therapeutic option for individuals with mild to moderate osteoarthritis of the knee.