Patient Instructions for Steroid Injections
and Viscosupplementation

Steroid Injections
Dr. Berman may elect to inject your joint with a steroid fluid or “cortisone” in order to reduce the pain and inflammation that you may have experienced. Please note that not everyone will have a lasting response following the injection. However, many patients experience significant decreased swelling, decreased pain, increased range of motion, and improved function. Here is some information that he would like you to know:

1. The injection consists of two medications: Cortisone (a steroid) and Marcaine (a numbing agent).
2. It is recommended that you refrain from any high level activities using your knee for approximately 48 hours. Routine activities including walking are permitted.
3. Occasionally individuals with dark complexions may experience some skin discoloration locally at the site of the injection.
4. There is also the possibility of an increase in discomfort within 48 hours of the injection. This is called a “steroid flare-up.” To help avoid this, abide by the activity restriction above.
5. There is a small chance of infection (less than 1%). You should contact Dr. Berman’s office immediately at 817-375-5200 or Andrea Wylie, RN at 817-375-5271 if you notice any of the following signs or symptoms:

• Redness of the knee
• Increased warmth of the entire knee
• Drainage from the injection site
• Fever over 100 degrees
  

Viscosupplementation
Dr. Berman may elect to try improving your knee function through a series of injections called viscosupplementation. He will discuss whether you are a candidate for these injections. These are a series of three injections over three consecutive weeks, one a week into your knee. The injection is a thick fluid that binds with your own articular cartilage and joint fluid to give your knee an increase in the “hydraulic” fluid mechanism of your knee joint. It works best with moderate degenerative joint disease but can also give relief in some cases to patients with advanced disease. Often patients can get as much as 6 months relief from their pain with a product called Synvisc. The series can be repeated twice per year. Synvisc is typically very well tolerated but Dr, Berman wants you to know about some potential problems.

1. It is recommended that you refrain from any high level activities using your knee for approximately 48 hours. Routine activities including walking are permitted.
2. Often patients do not experience any relief of symptoms until after the second in the series of three injections.
3. The most commonly reported side effects are temporary pain, swelling and/or fluid accumulation in the injected knee. (About 2% of all injections) If the fluid accumulation is prolonged or painful call our office.
4. Some patients have reported occasional rash. Advise Dr. Berman or Andrea is you are allergic to chicken products.
5. There is a small chance of infections (less than 1%). You should contact Dr. Berman’s office immediately at 817-375-5200 or Andrea Wylie, RN at 817-375-5271 if you notice any of the following signs or symptoms:
   • Redness of the knee
   • Increased warmth of the entire knee
   • Drainage from the injection site
   • Fever over 100 degree

    

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