Knee Injections for Arthritis Explained by Dr. Mayur Rabhadiya

Understanding Knee Injections for Arthritis

Knee injections may be considered when knee arthritis remains painful despite an appropriate programme of exercise, physiotherapy, activity modification and medically suitable pain relief.

An injection should not be selected only because another patient received it or because it is described as advanced, biological or cartilage-restoring.

Dr. Mayur Rabhadiya recommends knee injections according to:

The correct diagnosis
Arthritis severity and distribution
Pain and swelling pattern
Knee movement
Limb alignment
Previous treatment
Medical conditions
Patient expectations
Likelihood of meaningful symptom improvement

The principal injection categories used for knee arthritis include:

Corticosteroid injections
Hyaluronic acid injections
Platelet-rich plasma
Growth Factor Concentrate therapy

These injections differ in their proposed mechanism, evidence, cost, preparation and expected duration of benefit.

No injection can guarantee pain relief, regenerate established cartilage or permanently prevent knee replacement.

Patients seeking the broader treatment pathway can first read about non-surgical knee arthritis treatment in Mumbai.

When Is a Knee Injection Considered?

A knee injection may be considered when:

Pain persists despite exercise and activity modification
Topical or oral medicines are unsuitable
Medicines cause significant side effects
A temporary arthritis flare limits rehabilitation
Pain prevents participation in physiotherapy
Surgery is not currently required
Surgery must be delayed for medical reasons
The patient understands the likely benefits and limitations

An injection should normally form part of a wider treatment programme rather than become the only treatment.

Relief from an injection may create an opportunity to improve:

Muscle strength
Walking tolerance
Weight management
Exercise participation
Daily activity

If the patient becomes inactive again as soon as pain improves, the functional benefit may be limited.

Confirming the Diagnosis Before an Injection

Not every painful or swollen knee should be injected.

Symptoms may arise from:

Osteoarthritis
Meniscal disease
Gout
Inflammatory arthritis
Infection
Ligament instability
Tendon problems
Referred pain from the hip or spine
Previous injury
A fracture or bone condition

A hot, severely swollen knee associated with fever or systemic illness requires assessment for infection or another acute condition.

Injecting a knee without confirming the diagnosis can delay appropriate treatment.

Assessment may include:

Symptom history
Clinical examination
Knee alignment
Movement and stability
Weight-bearing X-rays
Blood tests or joint-fluid testing in selected cases

MRI is not routinely required before every arthritis injection.

Corticosteroid Injection

A corticosteroid, also called cortisone or steroid, is an anti-inflammatory medicine injected into the knee joint.

It may be considered when:

The knee is inflamed or swollen
Pain has temporarily increased
Other medicines are unsuitable
Short-term relief is needed to support rehabilitation
A patient cannot currently undergo surgery

Corticosteroid injections tend to provide short-term rather than permanent relief.

The response varies. Some patients experience useful improvement, while others obtain little or no benefit.

Steroid injections do not:

Regrow cartilage
Restore lost joint space
Correct deformity
Reverse advanced arthritis
Guarantee avoidance of knee replacement

Repeated steroid injections should not be given automatically whenever pain returns. The diagnosis, previous duration of benefit and cumulative risks should be reviewed.

Important Steroid-Injection Precautions

Corticosteroid injections may temporarily increase blood glucose, particularly in patients with diabetes.

Other considerations include:

Temporary post-injection pain
Facial flushing
Skin or fat changes near the injection site
Infection
Bleeding
Allergic reaction
Possible effects of repeated injections on joint tissues
Timing before planned knee replacement

Patients with diabetes should monitor glucose according to medical advice.

If knee replacement is being considered, the timing of any injection should be discussed with the surgeon. Injections should not be arranged independently shortly before planned surgery.

A dedicated page will provide a more detailed discussion of cortisone injections.

Hyaluronic Acid or Gel Injections

Hyaluronic acid injections are also described as gel injections or viscosupplementation.

Hyaluronic acid is a substance normally present in joint fluid. Injected products are intended to supplement the joint environment and may reduce symptoms in some patients.

Evidence is inconsistent, and major guidelines do not uniformly recommend routine use.

Potential reasons for considering hyaluronic acid may include:

Intolerance of anti-inflammatory medicines
A preference to avoid corticosteroid injection
Previous useful response
Mild or moderate arthritis in a selected patient
Understanding that the benefit is uncertain

Hyaluronic acid does not recreate normal cartilage or restore lost joint space.

Patients should be informed that:

Improvement is not guaranteed
Benefit may take time to appear
Results vary between products and patients
Relief, when present, is temporary
Advanced deformity may reduce the likelihood of benefit

Platelet-Rich Plasma Injection

Platelet-rich plasma, or PRP, is prepared from the patient’s own blood.

Blood is collected and processed to produce a plasma fraction containing a higher concentration of platelets than the original sample. The preparation is then injected into the knee.

Platelets release several biological mediators that may influence inflammation and tissue signalling.

PRP may improve pain and function in selected patients, but research results vary because of differences in:

Platelet concentration
White-cell concentration
Activation methods
Processing systems
Number of injections
Arthritis severity
Study design

PRP is not one uniform product.

It should not be described as a treatment that reliably regenerates cartilage or reverses established osteoarthritis.

A separate Menu 4 page will cover PRP patient selection, preparation and evidence in greater detail.

GFC Therapy

Growth Factor Concentrate, commonly called GFC therapy, is another blood-derived injection.

A sample of the patient’s blood is processed using a specific preparation system intended to concentrate or release selected platelet-derived growth factors.

The terminology and preparation protocols are not identical across all products. Evidence relating to one platelet-derived system should not automatically be assumed to apply to every GFC or PRP preparation.

GFC therapy may be considered for selected patients with symptomatic knee arthritis, particularly when:

Symptoms remain significant despite core treatment
The arthritis stage is clinically appropriate
Major fixed deformity is absent
Knee movement remains reasonably preserved
Expectations are realistic

GFC therapy does not reliably:

Regrow established cartilage
Reverse bone-on-bone arthritis
Correct bow-leg or knock-knee deformity
Restore severely reduced movement
Prevent future replacement in every patient

Read the detailed guide to GFC therapy for knee arthritis.

Patients comparing platelet-derived injections can also read GFC therapy versus PRP.

Which Knee Injection Is Best?

There is no single best injection for every patient.

The appropriate choice depends on:

Diagnosis
Arthritis stage
Presence of swelling
Previous injection response
Diabetes
Blood-thinning medicines
Surgery plans
Cost
Availability
Evidence quality
Patient preference

A steroid injection may be more appropriate when short-term anti-inflammatory relief is required.

A platelet-derived injection may be considered in a selected patient seeking possible longer symptom improvement, with an understanding that the evidence and response remain variable.

Hyaluronic acid may be considered selectively, but it is not routinely recommended by several major guidelines.

The correct answer is therefore not simply that the newest or most expensive injection is best.

How Long Do Knee Injections Last?

The duration of relief varies considerably.

It depends on:

Injection type
Arthritis severity
Joint inflammation
Deformity
Muscle strength
Body weight
Activity level
Previous response
Accuracy of diagnosis
Rehabilitation after injection

Corticosteroid relief is commonly short term.

Hyaluronic acid, PRP and GFC may provide longer relief in some patients, but benefit is inconsistent and cannot be promised.

A temporary reduction in pain should not be interpreted as permanent structural improvement.

The patient should assess whether the injection produced a meaningful change in:

Walking
Stair use
Sleep
Chair-rise
Exercise participation
Pain-medicine use

Can an Injection Treat Bone-on-Bone Arthritis?

An injection may provide temporary symptom relief in some patients with advanced arthritis.

However, the probability and duration of meaningful benefit may be lower when there is:

Complete joint-space loss
Severe deformity
Major stiffness
Significant instability
Persistent rest pain
Marked walking restriction

An injection cannot restore a severely damaged joint.

It may still be considered when:

Surgery is not currently desired
Surgery is medically unsuitable
Temporary relief is needed
Expectations remain realistic

Repeated injections should not be used only to postpone necessary reassessment when disability continues to progress.

Can Injections Prevent Knee Replacement?

No injection can guarantee that knee replacement will never be required.

An injection may help a patient:

Continue non-surgical care
Improve exercise participation
Manage symptoms temporarily
Delay surgery appropriately
Prepare medically or practically for future treatment

Delay is beneficial only when the patient maintains acceptable function and quality of life.

Continuing ineffective injections while walking ability, sleep and independence deteriorate is not necessarily preferable to surgical assessment.

Risks of Knee Injections

Potential risks vary according to the product but may include:

Infection
Bleeding
Temporary pain flare
Swelling
Allergic reaction
Skin changes
Injury to surrounding structures
Failure to improve
Temporary blood-glucose elevation after steroid injection

Infection following injection is uncommon but potentially serious.

Seek prompt medical assessment for:

Increasing redness
Severe swelling
Fever
Chills
Increasing warmth
Inability to bear weight
Rapidly worsening pain

Mild discomfort for a short period after injection can occur, but progressive deterioration should not be observed without assessment.

Blood Thinners and Knee Injections

Patients taking blood-thinning medicines should inform the clinician before injection.

These may include:

Aspirin
Clopidogrel
Warfarin
Apixaban
Rivaroxaban
Dabigatran
Injectable anticoagulants

The medicine should not be stopped independently.

The injection plan depends on:

The specific medicine
Reason for anticoagulation
Bleeding risk
Previous blood clots
Kidney function
Injection technique

Stopping an anticoagulant without appropriate advice may create a greater risk than proceeding with it.

What to Expect After a Knee Injection

After the procedure, patients may be advised to:

Avoid strenuous activity for a short period
Continue gentle movement
Monitor the injection site
Use prescribed pain relief if required
Resume exercise gradually
Contact the clinic if symptoms worsen

A short-lived increase in discomfort may occur.

The patient should not test the injection by immediately undertaking prolonged walking, running or heavy exercise.

The longer-term objective is to use symptom improvement to support rehabilitation and function.

When an Injection Should Be Reconsidered

Another injection should not be given automatically because the previous one helped briefly.

Reassessment is needed when:

Relief lasted only a few days
Each injection provides shorter benefit
Pain is progressively worsening
Deformity is increasing
Walking remains substantially restricted
Strong pain medicines are still required
The diagnosis is uncertain
Surgery is being planned
Previous injections caused complications

If several well-selected injections have failed, changing only the brand or processing system may not solve the underlying problem.

Frequently Asked Questions About Knee Injections

What injections are available for knee arthritis?

Common categories include corticosteroid, hyaluronic acid, PRP and GFC injections.

Which injection is best for knee arthritis?

There is no single best option. Selection depends on arthritis severity, inflammation, medical conditions, evidence and previous treatment.

Which injection works fastest?

Corticosteroid injections may produce relatively rapid relief in some patients, although the benefit is usually short term.

Which injection lasts longest?

Duration varies considerably. PRP, GFC or hyaluronic acid may provide longer relief in some patients, but this cannot be guaranteed.

Do knee injections regrow cartilage?

No available injection has been established as reliably regrowing normal cartilage in established knee osteoarthritis.

Can a knee injection cure arthritis?

No. Injections are symptom-management treatments, not cures for structural arthritis.

Are knee injections painful?

Temporary discomfort can occur during and after the procedure. Experience varies with technique and individual sensitivity.

Can an injection worsen knee pain?

A temporary post-injection flare may occur. Severe or progressively worsening pain requires assessment.

Are steroid injections safe for diabetes?

They may temporarily increase blood glucose. Diabetic patients require appropriate monitoring and counselling.

How many steroid injections can be taken?

There is no universal number. Frequency should be limited and based on previous benefit, arthritis severity, risks and future surgery plans.

Are gel injections recommended for everyone?

No. Evidence is inconsistent, and several guidelines do not recommend routine use.

Is PRP the same as GFC?

No. Both are blood-derived, but preparation and composition differ. The terminology and systems are not standardised.

Is GFC better than PRP?

Current evidence does not establish one preparation as universally superior for every patient.

Can injections help bone-on-bone arthritis?

Temporary relief is possible, but the likelihood of substantial or durable improvement may be lower in advanced disease.

Can I take an injection while using blood thinners?

Possibly, but the medicine and bleeding risk must be reviewed. Do not stop blood thinners independently.

Can I exercise after an injection?

Gentle activity is usually allowed, followed by gradual return to exercise according to the clinician’s instructions.

When should injections be stopped?

They should be reconsidered when relief is minimal, short-lived or when pain and disability continue to progress.

When should knee replacement be discussed?

Replacement assessment becomes reasonable when advanced arthritis causes substantial pain and functional loss despite appropriate non-surgical treatment.

About Dr. Mayur Rabhadiya

Dr. Mayur Rabhadiya is an Orthopedic & Joint Replacement Surgeon in Mumbai.

His qualifications include MBBS, D’Ortho, DNB Orthopedics, MNAMS Orthopedics and a Fellowship in Robotic & Computer-Navigated Joint Replacement.

His approach to knee injections is evidence-based and patient-specific. An injection is advised only after confirming the diagnosis, considering arthritis severity and discussing realistic benefits, risks and alternatives.

His clinical practice includes knee arthritis assessment, selected GFC therapy, total knee replacement, partial knee replacement, robotic knee replacement, bilateral knee replacement and revision knee replacement.

Last medically reviewed: June 2026.

Book a Knee Arthritis Injection Consultation in Mumbai

Patients considering a knee injection or seeking an opinion about cortisone, hyaluronic acid, PRP or GFC therapy can consult Dr. Mayur Rabhadiya at Ghatkopar East or Ghatkopar West, Mumbai.

Call +91 84249 03913 or +91 96113 30063.

Appointments can also be requested through the orthopedic doctor consultation page.

Medical References

This patient-education page is informed by current recommendations from the National Institute for Health and Care Excellence and the American Academy of Orthopaedic Surgeons concerning intra-articular corticosteroid, hyaluronic acid and platelet-rich plasma injections for knee osteoarthritis.

Medical Disclaimer

This information is intended for general patient education and does not replace clinical examination or personalised injection advice.

Injection selection depends on the diagnosis, arthritis severity, medical history, medicines, previous treatment and planned surgery. No injection can guarantee pain relief, cartilage regeneration or prevention of knee replacement.