From the Guidelines
Knee edema treatment involves intra-articular injection of long-acting glucocorticoids for acute exacerbation of knee pain, especially if accompanied by effusion.
Treatment Options
- Intra-articular injection of glucocorticoids: indicated for acute exacerbation of knee pain, especially if accompanied by effusion, as recommended by EULAR 1
- Hyaluronic acid: may be effective in knee osteoarthritis, but the size effect is relatively small, and suitable patients are not well defined 1
- Topical agents: such as NSAIDs and capsaicin, can be used as initial treatments for osteoarthritis of the knee 1
- Acetaminophen: can be used as an initial treatment for osteoarthritis of the knee, but NSAIDs have exhibited superiority in those with moderate-to-severe OA pain 1
- Nonsteroidal anti-inflammatory drugs (NSAIDs) or COX-2 inhibitors: can be used as initial treatments for osteoarthritis of the knee 1
- Duloxetine: can be used to treat patients with osteoarthritis, with significant reductions in pain outcomes and improvement in physical function 1
Important Considerations
- Contextual factors: such as effective communication, patient expectations, and the setting in which the procedure takes place, can influence the outcome of intra-articular therapies 1
- Placebo effect: should be recognized as a potential factor in the outcome of intra-articular therapies 1
- Opioids: are not recommended for managing osteoarthritis pain due to limited benefit and high risk of adverse effects 1
From the Research
Treatment Options for Knee Edema
The treatment for knee edema depends on the underlying cause of the swelling. Some possible treatments include:
- Joint aspiration followed by synovial fluid white cell count (WCC), microscopy and/or culture to determine the cause of the swelling 2
- Surgical modalities such as subchondroplasty (SCP) and core decompression (CD) for the management of bone marrow edema of the knee joint 3
- Intermittent pneumatic compression therapy in addition to conventional treatment for patients with knee osteoarthritis 4
- Arthroscopic treatment for rare conditions such as lipoma arborescens 5
Non-Surgical Management
Non-surgical management of knee edema may include:
- Cold-pack treatment along with conventional treatment such as ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, and exercise 4
- Measurement of knee swelling using bioimpedance spectroscopy, handheld 3D scanning technology, or magnetic resonance imaging to monitor progress and treatment 6
Surgical Management
Surgical management of knee edema may include:
- Subchondroplasty (SCP) for patients with varied stage of osteoarthritis associated with subchondral bone marrow edema 3
- Core decompression (CD) for patients without findings of osteoarthritis who fail to respond to conservative treatment 3
- Arthroscopic treatment for conditions such as lipoma arborescens 5