Each knee option has a different use

Home care belongs before a procedure

Shorter walks, gentle strength work and a fitted cane may ease the load. You don’t have to stop moving unless a clinician says otherwise.

Heat or cold may feel good, depending on your knee. Check with your doctor before taking medicine that could affect other health problems.

A sensible choice needs to fit your health and daily limit. It shouldn’t win simply because its name sounds newer.

Cortisone is usually the quicker short-term choice

Cortisone may ease soreness sooner than gel or blood-based choices. The relief often fades, so it’s useful to set a review date.

If surgery is planned, both the cortisone shot and operation dates matter. A recent shot may raise infection risk, so tell both clinicians.

Gel injections for knee soreness have mixed value

Gel acts like some fluid already found inside the knee. It doesn’t rebuild worn tissue or promise easier walking.

Insurance coverage and the number and timing of visits can vary. You’ll want the product name, visit count, total price and follow-up details.

If the knee stays sore, other choices can be discussed

QC Kinetix calls its blood-based, non-surgical choices regenerative treatments. Its medical providers are clinicians who’ll check the knee before discussing any procedure.

Concentrated platelet-rich plasma, or PRP, is blood that’s drawn, spun to gather platelets, then placed into your knee. They can also explain knee surgery alternatives, meaning choices that don’t involve an operation.

Sources

1. The 2019 ACR/Arthritis Foundation OA guideline makes a STRONG recommendation for intra-articular glucocorticoid injection in knee OA, alongside strong recommendations for exercise, weight loss, self-management, tai chi, cane use, bracing and NSAIDs; intra-articular steroid injection for HAND OA is only conditionally recommended.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.

2. The 2015 Cochrane review of 27 trials (1,767 participants) found intra-articular corticosteroid better than sham for knee OA pain (SMD -0.40, 95% CI -0.58 to -0.22; NNTB 8), but the benefit decayed with time: moderate at 1-2 weeks, small at 13 weeks, and no evidence of any effect at 26 weeks. All outcomes were graded LOW quality.

   Jüni P, et al. — Intra-articular corticosteroid for knee osteoarthritis.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD005328.pub3.

3. In a 2-year double-blind RCT of 140 patients with symptomatic knee OA and ultrasound synovitis, 40 mg intra-articular triamcinolone every 12 weeks produced significantly greater cartilage volume loss than saline (index compartment cartilage thickness change -0.21 mm vs -0.10 mm; between-group difference -0.11 mm, 95% CI -0.20 to -0.03) with no significant difference in knee pain.

   McAlindon TE, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.

4. A 2-year double-blind RCT of triamcinolone every 3 months versus saline found NO difference in joint space loss between groups and significantly improved pain and stiffness with repeated steroid injections, and the authors concluded that long-term intra-articular steroid injection is safe for the anatomical structure of the knee.

   Raynauld JP, et al. — Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial.. Arthritis Rheum, 2003. DOI: 10.1002/art.10777.

5. A 2022 BMJ systematic review and meta-analysis of 169 trials (21,163 participants) found viscosupplementation produced only a small pain reduction versus placebo (SMD -0.08, 95% CI -0.15 to -0.02; about -2.0 mm on a 100 mm VAS), below the minimal clinically important difference, and trial sequential analysis indicated conclusive evidence of clinical equivalence with placebo since 2009.

   Pereira TV, et al. — Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2022-069722.

6. The RESTORE randomized trial (288 participants, leukocyte-poor PRP, 3 weekly injections) found no significant difference from saline placebo at 12 months in knee pain (-2.1 vs -1.8 points; difference -0.4, 95% CI -0.9 to 0.2) or in medial tibial cartilage volume (-1.4% vs -1.2%), with 29 of 31 secondary outcomes also showing no between-group difference.

   Bennell KL, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

7. The 2025 Cochrane living review of stem cell injections for knee OA (25 trials, 1,341 participants) found stem cell injection MAY slightly improve pain and function up to six months versus placebo (pain 1.2 points better on a 0-10 scale; function 14.2 points better on 0-100), but rated the evidence LOW certainty for both, downgraded for indirectness and suspected publication bias, with up to three larger RCTs withdrawn before reporting results.

   Whittle SL, et al. — Stem cell injections for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2025. DOI: 10.1002/14651858.CD013342.pub2.

8. FDA's HCT/P guidance sets out the minimal-manipulation and homologous-use criteria that decide whether a human cell or tissue product is regulated solely under 21 CFR Part 1271 (section 361) or requires a biologics licence; cell-based orthopaedic injections that fall outside those criteria are unapproved drugs and biological products, and no cell-based product is FDA-approved to treat osteoarthritis.

   U.S. Food and Drug Administration — Regulatory Considerations for Human Cells, Tissues, and Cellular and Tissue-Based Products: Minimal Manipulation and Homologous Use - Guidance for Industry and FDA Staff. U.S. Food and Drug Administration, 2020.

9. Medicare Part B claims show hyaluronic acid injections rose from 1,090,503 services in 2012 to 1,209,489 in 2018 and total costs from $290.10 million to $325.02 million (2020 dollars) - utilisation and spending both increased despite the AAOS recommendation against routine use.

   Zhu KY, et al. — Hyaluronic Acid Injections for Knee Osteoarthritis: Has Utilization Among Medicare Beneficiaries Changed Between 2012 and 2018?. J Bone Joint Surg Am, 2022. DOI: 10.2106/JBJS.21.00832.

10. A BMJ network meta-analysis of 10 large trials in 3,803 patients found glucosamine, chondroitin and their combination all failed to reach the prespecified minimal clinically important difference versus placebo for OA pain (glucosamine -0.4 cm, chondroitin -0.3 cm, combination -0.5 cm on a 10 cm VAS). Industry-independent trials showed SMALLER effects than commercially funded ones (P=0.02 for interaction).

    Wandel S, Juni P, Tendal B, et al. — Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis.. BMJ, 2010. DOI: 10.1136/bmj.c4675.

11. In a placebo-surgery-controlled trial of 180 patients with knee OA, neither arthroscopic debridement nor arthroscopic lavage outperformed placebo surgery at ANY time point over 24 months on any of five self-reported pain/function scales or an objective walking and stair-climbing test.

    Moseley JB, O'Malley K, Petersen NJ, et al. — A controlled trial of arthroscopic surgery for osteoarthritis of the knee.. New England Journal of Medicine, 2002. DOI: 10.1056/NEJMoa013259.

12. In a double-blind, sham-controlled trial of 146 patients aged 35-65 with a degenerative medial meniscus tear and NO knee osteoarthritis, arthroscopic partial meniscectomy produced no significant benefit over sham surgery on any primary outcome at 12 months (Lysholm 21.7 vs 23.3 points; WOMET 24.6 vs 27.1; pain after exercise 3.1 vs 3.3).

    Sihvonen R, Paavola M, Malmivaara A, et al. — Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear.. New England Journal of Medicine, 2013. DOI: 10.1056/NEJMoa1305189.