cortisone injection before knee replacement

Cortisone Injections Before Knee Replacement (My Experience)

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Cortisone shots are injections of synthetic corticosteroid that your body naturally produces. They often relieve pain and reduce inflammation in your knee joint (and other areas too). But is it wise to have a cortisone shot before surgery? Will a cortisone shot delay TKR surgery?

You will receive benefits from a cortisone shot.  It can relieve pain and inflammation from 6 weeks to 6 months. A cortisone injection can usually be given in the doctor’s office in only a few minutes. The pain is minimal.

In this article we’ll discuss some of the common questions and misconceptions of cortisone shots.  I’ll share my experience with a number of cortisone shots in my knee and I’ll share information I learned about the cortisone shot I received a few months before getting knee replacement surgery.

My Experience With Cortisone Injections

I’ve had cortisone shots in my knee and in my fingers with positive results. The shots in my knee have occurred over a period of 40 years. I have only had shots in my fingers during the last few years when I developed trigger finger.

In this article, I want to talk about my experience with the injections I received in my knee.

When I first injured my knee 40 years ago, my first doctor drained the fluid that had built up in my knee after my basketball injury and then he administered a few cortisone shots over a period of months before it was decided that I needed surgery to repair a torn meniscus

Even though the first shots I received were done without ultrasound or imaging, they reduced my pain and inflammation immediately. Unfortunately, I did not know my meniscus was torn and when I resumed playing basketball my knee twisted and swelled up again and again.

After two surgeries on the meniscus in my mid-twenties, I did not receive any cortisone shots for more than 20 years. In my fifties, I began to feel more knee pain and had some swelling so I visited an orthopedic surgeon who began to administer cortisone shots once or twice a year when I felt like I needed one.

I had the injections for a few years but decided that they were merely temporary and did not really fix my problem. I decided to just live with the pain.

Next, I tried a series of hyaluronic acid injections. I had several friends who had success with hyaluronic acid injections. Again, my injections were given without ultrasound or imaging. After a series of 6 injections, I did not improve.

Unfortunately, I seemed to be one of the people who did not benefit from the injections. At that time the doctor told me I would need a knee replacement and when the pain became unbearable, that I should return for the procedure.

Related: Must Have Items for Knee Replacement

I waited 15 years before returning to see an orthopedic surgeon who confirmed the fact I needed a TKR procedure. Hoping for an alternative I visited a Jobe-Kerlin clinic where they confirmed the need for TKR but at the same visit, I received a cortisone injection for temporary pain relief.

This injection was done with the aid of ultrasound. The doctor cleaned the area, drained 22 cc’s of fluid in my knee, numbed the knee, applied a gel and injected the cortisone.

With the removal of the fluid and the cortisone injection, I felt better immediately.  There were no side effects or pain and I was able to resume my normal activity.

Do Cortisone Injections Cause Pain

In my case the answer is no. Over the forty years that I had cortisone injections not once did they cause pain or any other medical complications. There was no swelling, bleeding or discomfort.

The doctor always numbed the area before injecting the cortisone. As I mentioned earlier my first injections took place without any imaging.

The last several years the doctor used ultrasound and he allowed me to watch the procedure on the screen with him. After each injection, I was able to resume my normal activity unless I had injured the knee. I was advised to keep the area clean and avoid hot tubs and swimming pools for a few days.

Is It Wise To Receive A Cortisone Injection Prior to TKR (Will It Delay My TKR Surgery)

In my case I received a cortisone injection at the end of January and had my surgery at the end of May. When I received my injection my doctor told me it would help for 2 to 3 months.

He said he could have given me a different injection that would last longer but if I was contemplating TKR it is not wise to have an injection close to the time you are having surgery.

According to him, the shots can adversely affect your immune system and can increase the risk of post-surgery infection.

If you have a cortisone injection and then decide like me to have surgery, it is probably wise to delay the surgery. Consult your doctor for a suggested wait time between cortisone injections and surgery.

Related: Best Shoes After Knee Replacement

Precautions Before Receiving a Cortisone Injection

Let your doctor know if you are using other medications. My doctor always asked me if I was taking any other medications before administering the injection.

According to him, other medications, especially blood thinners could have an adverse effect. Let your doctor know if you are allergic to the numbing anesthetic he or she might use.

Remember that cortisone shots are part of an overall therapy plan. You should consider regular exercise and or physical therapy when needed to strengthen the muscles. A cortisone injection is for temporary relief. You may need to make permanent lifestyle changes.

If you are overweight you should consider changing your diet and exercise regimen. You might consider changing your footwear even if it means spending more money on shoes.

You may also want to invest in some other knee aids like compression braces, icing and heating devices to name a few.

Related: Best Vitamins and Supplements for Knee Replacement

Negatives Of A Cortisone Shot in the Knee

According to my research cortisone injections can soften cartilage when injected into the joint. In my case I no longer have any cartilage in my joint so this is no longer a concern for me.

If injected directly into tendons like your Achilles, it can have a weakening effect on the tendon. Allergic reactions are uncommon.

If you have a reaction to the injection or the anesthetic or if you experience prolonged swelling, bleeding or infection notify your doctor immediately. Take your doctor’s advice and limit the amount of injections and the length of time between injections.

Conclusion

In my case, I can honestly say that I have benefited from cortisone injections. This is true of my knee injections as well as the few injections I have had in my fingers.

Remember that cortisone shots only offer temporary pain relief. They will not fix your knee. There will probably come a time when you decide that knee surgery or a knee replacement is necessary for more lasting relief.

Also be careful to alert your doctor if you are taking other medications. Take a good look at your lifestyle including your weight, your diet and your exercise program.

Changes in your lifestyle may allow the cortisone shots to be more successful. For me, cortisone injections were one of many alternatives to surgery that I tried. I wanted to consider TKR as a last resort and I researched safe alternatives before deciding on TKR.

Like me, you should examine your overall lifestyle, do some research and consult your physician to see if cortisone injections are for you. If you decide to go forward and have the injections I hope that they are as successful for you as they have been for me.

Comments

  1. I just got cortisone shots in both knees yesterday. I’m going to be going on vacation next week and I want to be able to enjoy myself as much as possible. I will be having TKR, but I haven’t been scheduled yet. The nurse said I’ll need to wait two months.

    That’s why I searched for information and found your helpful post. Thanks.

  2. I’ve had cortisone injections twice now in both knees. Bone on bone. Osteoarthritis in both. The last injections took affect right away. It’s been almost three months now and still working, although starting to get little pain in both now. For the first two months I almost forgot I had bad knees. No pain whatsoever. Not ready to jump in the new knee line yet so the shots are a huge blessing.

    1. Author

      Good to hear they are working for you, even if it’s temporary. I waited as long as I could and the shots did help me. Thanks for the comment.

  3. Ken, what about cortisone injections in the thumb joints? I also have arthritis in them but the knees are worse. First TNR end of June but right now my thumbs are very painful.

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