Knee Joint Injection

About this injection

The knee is the largest joint in the body and a common site of pain from osteoarthritis, bursitis, and inflammatory conditions. Intra-articular corticosteroid injection delivers anti-inflammatory medication directly into the joint space, providing rapid and meaningful pain relief.

Dr Hasham injects the knee using a medial or lateral parapatellar approach — a straightforward, well-established technique that achieves reliable joint entry. The procedure takes under 30 minutes and most patients can walk home the same day.

Injection is particularly effective where there is a joint effusion (fluid on the knee), as the fluid itself confirms intra-articular placement and is aspirated before the steroid is injected.

Conditions treated

• ✓Knee osteoarthritis — the most common indication; reduces pain and improves function
• ✓Joint effusion — fluid on the knee from any cause; aspiration relieves pressure
• ✓Prepatellar bursitis (housemaid's knee) — inflammation of the bursa in front of the kneecap
• ✓Infrapatellar bursitis — inflammation below the kneecap
• ✓Inflammatory arthritis — rheumatoid arthritis, psoriatic arthritis, gout
• ✓Post-traumatic knee inflammation
• ✓Symptomatic meniscal degeneration with associated synovitis

Symptoms

• —Knee pain on weight-bearing, stairs, and rising from a chair
• —Morning stiffness lasting more than 30 minutes
• —Swelling and warmth around the knee
• —Restricted range of movement
• —Crepitus (grinding sensation) on movement
• —Night pain disturbing sleep

Assessment & diagnosis

Assessment includes evaluation of compartment tenderness, range of movement, effusion (bulge sign, patella tap), ligament stability, and meniscal provocation tests. X-rays are useful to confirm the degree of osteoarthritis. Clinical findings guide whether aspiration alone or injection is most appropriate.

Treatment options

What happens on the day

1. Clinical assessment and confirmation of diagnosis
2. Patient positioned supine with knee slightly flexed over a rolled towel
3. Landmarks identified — patella, medial and lateral joint line
4. Skin cleaned with antiseptic
5. Corticosteroid and local anaesthetic prepared
6. Needle inserted medial or lateral to the patella, directed into the joint space
7. Aspiration of any effusion prior to injection
8. Corticosteroid injected smoothly
9. Needle withdrawn, pressure applied, dressing applied
10. Patient advised to rest and given written aftercare instructions

Injection technique

The medial parapatellar approach is most commonly used. With the patient supine and the knee extended, the needle is inserted midway along the medial border of the patella, angled slightly posteriorly toward the joint space. If a significant effusion is present, it is aspirated before the steroid is injected through the same needle. Methylprednisolone 40mg or triamcinolone 40mg in 2–5ml local anaesthetic is used.

Risks & side effects

• —Post-injection flare — temporary increase in pain within 24 hours, settling within 2–3 days
• —Infection (septic arthritis) — rare but serious; sterile technique is essential
• —Cartilage effects — repeated injections may accelerate cartilage loss; limit to 3–4 per year
• —Blood glucose elevation in diabetic patients — monitor carefully
• —Skin depigmentation or fat atrophy at injection site
• —Facial flushing — transient

Aftercare

• ✓Rest the knee for 24–48 hours after injection
• ✓Avoid high-impact activity for 2 weeks
• ✓Use ice for 10–15 minutes to manage post-injection flare
• ✓Effect builds over 48–72 hours and peaks at 1–2 weeks
• ✓Begin quadriceps physiotherapy once pain has settled
• ✓Return for review if no improvement after 4–6 weeks

Frequently asked questions