What is Joint Preservation?
When cartilage deterioration due to osteoarthritis is causing persistent joint pain that interferes with your daily life, it is our goal to restore normal movement and alleviate pain to your joint – be it your shoulder, hip, or knee. Joint preservation refers to the use of nonsurgical or surgical means to preserve a deteriorating joint in order to delay or avoid joint replacement surgery. Every patient is different, so our specialists will customize your joint preservation strategy with you based on your individual situation, taking into account factors such as your age, expectations, level of joint dysfunction, and activity level.
Nonsurgical Joint Preservation Techniques
Surgical Joint Preservation Techniques
What is Joint Injection?
For patients presenting with joint pain due to arthritis, the first step is usually conservative treatment, which includes but is not limited to medication and physical therapy (or a home exercise program).
If conservative treatment is not successful, you will likely proceed to interventional methods, or joint injections. The most common joint injections both seek to alleviate pain and increase range of motion. They are:
- Steroid Injections (or Cortisone Shots) – These injections are commonly used to reduce inflammation and provide relief from arthritis and joint pain.
- Hyaluronic acid (or “rooster comb”) injections – Also referred to as viscosupplementation, hyaluronic acid injections are used to treat osteoarthritis (most commonly in the knee).
Joint Injection Options
Steroid Injections
Steroid injections (or corticosteroid injections) work to reduce swelling and inflammation in the joint. They are commonly used in the knee, hip, and shoulder to relieve pain and swelling, but can also be used to treat pain in other joints including the elbow, wrist, and ankle.
There are benefits and drawbacks to steroid injections, including:
- Fast Relief – Steroid injections typically offer relief within 24-48 hours of the injection.
- Short-Term Relief – Pain relief from a steroid injection can last from 6-12 weeks.
- Limitations on Repeat Use – Steroid injections are often most effective the first time, with subsequent injections losing their efficacy. These injections also cannot be given too frequently without a risk of weakening the surrounding structures of the joint.
Speak to your physician to find out if steroid injections may be a good option for you.
Hyaluronic Acid Injections / Viscosupplementation
Hyaluronic acid is a natural lubricating component in the lining of your joints. However, as we age, our bodies produce this substance at a lower quantity and quality. In patients suffering from osteoarthritis, the hyaluronic acid thins even further, causing friction and pain as the joint operates.
Hyaluronic acid injections, also referred to as viscosupplementation, inject this substance back into the painful joint, coating and lubricating it to reduce friction and pain and increase range of motion.
Currently, the FDA has only approved viscosupplementation for use on the knee, but there is evidence to support its use in the hip and shoulder as well. These injections can be given safely if steroid injections have proven ineffective.
Fun Fact: Viscosupplementation is also referred to as “rooster comb injections” because many pharmaceutical companies extract hyaluronic acid from the cartilage of rooster combs. Synthetic hyaluronic acid can also be used for these injections.
Will Joint Injections Be Covered By My Insurance?
In most cases, insurance plans will cover the approved use of steroid injections and viscosupplementation. However, every insurance company has its own standards and guidelines, so it is best to verify your individual coverage prior to scheduling your joint injection.
Your Joint Preservation Team
Frequently Asked Questions
How do I know if I'm a better candidate for joint preservation versus joint replacement?
You may be a better candidate for joint preservation if your joint damage is not too advanced and your goal is to reduce pain, improve function, and delay or avoid joint replacement. Joint replacement may be considered when the joint is damaged beyond repair and conservative or preservation-focused treatments no longer provide enough relief. Joint preservation strategies are customized based on age, expectations, joint dysfunction, activity level, and each patient’s situation.
Are joint preservation treatments like PRP and BMAC injections covered by insurance?
Coverage for PRP, BMAC, and other orthobiologic treatments varies by insurance plan and is often limited. TSAOG advises patients considering PRP to check eligibility with their health insurance carrier and notes that few plans provide even partial reimbursement. Patients should confirm benefits, estimated costs, and coverage requirements before treatment.
How many treatment sessions or injections are typically needed before seeing results?
The number of sessions or injections depends on the treatment, diagnosis, severity of joint damage, and how your body responds. Some patients may start with one injection and follow up to assess symptom improvement, while others may need a series of treatments or a combined plan with therapy. Your provider will explain the expected timeline, number of visits, and follow-up plan before treatment begins.
Can joint preservation treatments be combined with physical therapy for better outcomes?
Yes, joint preservation treatments can often be combined with physical therapy when appropriate. Therapy may help improve strength, mobility, joint mechanics, and function while injections or other treatments help manage symptoms. Your TSAOG provider can recommend the right combination based on your joint, diagnosis, and activity goals.
How long can joint preservation treatments delay the need for a joint replacement?
Joint preservation treatments may delay joint replacement for some patients, but the timeline varies widely. Factors such as age, activity level, arthritis severity, cartilage condition, alignment, overall health, and treatment response all affect how long relief may last. TSAOG’s goal with joint preservation is to preserve the deteriorating joint and delay or avoid joint replacement when possible.
Take The Next Steps Toward Recovery
Find a Location Near You
TSAOG Orthopaedics & Spine at Westover Hills
TSAOG Orthopaedics & Spine at CHRISTUS Medical Center
TSAOG Orthopaedics & Spine at Brooks City Base
TSAOG Orthopaedics & Spine at Schertz Parkway
TSAOG Orthopaedics & Spine at New Braunfels
TSAOG Orthopaedics & Spine at Grayson Heights
TSAOG Orthopaedics & Spine near Alamo Quarry Market
TSAOG Orthopaedics & Spine at Ridgewood
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