Joint
Osteoarthritis & Meniscus
Non-surgical management of joint degeneration and meniscus conditions using PRP, shockwave therapy, and injection-based treatments to reduce pain and improve function.
Understanding osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis, affecting millions of adults. It occurs when the protective cartilage that cushions the ends of your bones gradually breaks down, leading to pain, stiffness, and reduced range of motion. While it was once thought of as simple "wear and tear," we now understand OA as a complex, active disease process involving inflammation, abnormal joint mechanics, and changes in bone structure.
Meniscus degeneration often accompanies knee osteoarthritis. Degenerative meniscal tears are extremely common and growing evidence suggests that many of these respond well to conservative and injection-based treatments rather than surgery.
Our approach focuses on slowing disease progression, managing symptoms, and preserving joint function using evidence-based, non-surgical interventions.
Diagnostic imaging
We use a combination of imaging modalities for joint conditions. Weight-bearing radiographs (X-rays) are the standard for assessing joint space narrowing and bony changes in osteoarthritis. Musculoskeletal ultrasound allows us to evaluate joint effusions, synovitis, and guide injections with precision. MRI may be ordered to evaluate meniscal tears, cartilage integrity, and bone marrow lesions when more detailed assessment is needed.
Conditions we treat
- Knee osteoarthritis
- Hip osteoarthritis
- Shoulder osteoarthritis
- Thumb (CMC) osteoarthritis
- Degenerative meniscal tears
- Meniscal degeneration
- Patellofemoral syndrome
- Ankle osteoarthritis
Treatment options
PRP injection (Platelet-Rich Plasma)
Intra-articular PRP injection delivers a concentrated dose of growth factors directly into the joint. For osteoarthritis, PRP works through multiple mechanisms: reducing inflammatory mediators within the joint, stimulating cartilage cell activity, and modifying the degenerative environment.
Multiple meta-analyses of randomized controlled trials have demonstrated that PRP provides superior and longer-lasting pain relief compared to hyaluronic acid (viscosupplementation) and corticosteroid injections for knee osteoarthritis. Effects typically last 6 to 12 months, and the treatment can be repeated.
We use high-dose, leukocyte-poor PRP for joint injections based on the current best evidence, prepared using a manual two-spin technique and delivered under ultrasound guidance.
Extracorporeal Shockwave Therapy (ESWT)
ESWT is an emerging non-invasive treatment for osteoarthritis that uses acoustic waves to stimulate tissue repair. For knee osteoarthritis, studies have shown improvements in pain, stiffness, and physical function scores. ESWT may work by reducing inflammatory mediators, stimulating cartilage metabolism, and improving subchondral bone remodeling.
Treatment is performed in-office and typically involves a series of sessions over several weeks. It can be used as a standalone treatment or in combination with PRP injection.
Corticosteroid injection
Intra-articular corticosteroid injections remain a well-established treatment for acute flares of osteoarthritis. They provide rapid anti-inflammatory relief, typically within days, and can be particularly useful for patients with significant joint effusion or synovitis.
While corticosteroids provide effective short-term pain relief (typically lasting 4 to 8 weeks), they do not modify the underlying disease process and current evidence suggests that repeated use may accelerate cartilage loss. For this reason, we use corticosteroid injections selectively and often recommend PRP as a longer-lasting alternative for patients who are candidates.
All joint injections are performed under ultrasound guidance to ensure accurate intra-articular placement.
What to expect
Your visit begins with a clinical evaluation, review of any prior imaging, and an in-office ultrasound assessment of the affected joint. We will discuss your imaging findings, the severity of your condition, and which treatment approach is most appropriate for your situation and goals.
For PRP injections, allow approximately 45 minutes for the full visit including blood draw, processing, and the ultrasound-guided injection. For corticosteroid injections, the procedure is faster — typically about 20 minutes. ESWT sessions last approximately 15 to 20 minutes per session.
We provide a post-procedure protocol for each treatment and schedule follow-up visits to assess your response. For osteoarthritis management, we take a long-term view — working with you over time to maintain joint function and manage symptoms as they evolve.
References
- Filardo G, Previtali D, Napoli F, et al. PRP injections for the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Cartilage. 2021;13(1 Suppl):364S-375S. doi:10.1177/1947603520931170
- Belk JW, Kraeutler MJ, Houck DA, et al. Platelet-rich plasma versus hyaluronic acid for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Am J Sports Med. 2021;49(1):249-260. doi:10.1177/0363546520909397
- McAlindon TE, LaValley MP, Harvey WF, 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;317(19):1967-1975. doi:10.1001/jama.2017.5283
- Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013;369(26):2515-2524. doi:10.1056/NEJMoa1305189
- Chen L, Ye L, Liu H, et al. Extracorporeal shock wave therapy for the treatment of osteoarthritis: a systematic review and meta-analysis. Biomed Res Int. 2020;2020:1907821. doi:10.1155/2020/1907821
- Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2020;72(2):149-162. doi:10.1002/acr.24131