What are infiltrations, what is it for and how are they carried out?

Infiltration is the giving a drug by injection anti-inflammatory and analgesic in the symptomatic place, being able to be inside a joint or in other areas. Infiltrations can be of the knee, hip, shoulder, lumbar ... and is performed to remove pain from the area and get fast recovery functionality.

When is it necessary to infiltrate?

Infiltration is indicated in those stubborn diseases to pharmacological treatment and before resorting to other more aggressive therapeutic options such as surgery.

It is used, above all, in pathologies of rheumatological and traumatic causes (, and chondropathies) and, especially, for the treatment of bursitis, capsulitis, tendonitis and enthesitis. The more infiltrated joints are:

• Shoulder
• Elbow
• Knee
• Hips
• Foot and hand
• Spine (usually performed with anesthetists, guided by scopia to locate the correct place of infiltration).

On some occasions, during the act of infiltration, we proceed to drain or empty the fluid content inside the joint. This procedure is known as arthrocentesis

Infiltrations caused by sport

They are usually due to a mechanical overload and particularly affect the joints of the knee, ankle, foot, shoulder and elbow, depending on the sport practiced:

• Knee: frequent in patella, ilitibial band (runners) and goose foot (tennis and paddle tennis). Also in ligamentous sprains and in incipient arthritic processes.
• Foot: frequent in (runners and soccer players) and Achilles bursitis.
• Elbow: Epicondylitis (tennis elbow) and epitrocleitis (golfer's elbow) tend to infiltrate.
• Shoulder: mainly due to tendonitis.
• Tobillo: Residual pain usually infiltrates after a subacute injury.

How is the infiltration done?

Infiltration or administration of the drug into the joint is a treatment simple and fast, although it requires knowledge of anatomy. It can be done in a ambulatory and does not require prior preparation.

The instruments used by the specialist are for personal use, that is, new material for each patient that is later thrown away: sterile gloves, disposable needles and syringes, sterile gauze and antiseptic, and a sterile cloth to cover the area.

It is necessary that the patient is correctly informed of the procedure and signs a consent to perform it in the consultation.

How long does it take to take effect?

The beneficial effect of infiltration does not become palpable until a few hours after inoculation. If the answer is favorable, other infiltrations can be carried out to eradicate all the symptoms, in which case we will space them between seven days and a month. In general, it is not recommended to infiltrate the same joint more than 4 times a year or to infiltrate more than three joints in the same medical visit.

If it is not effective, other alternatives such as rehabilitation and surgery.

What is the infiltrating liquid?

The liquid content that we infiltrate can be combined with Local anesthesia to minimize injection pain. In the same injection we can administer different types of drugs, depending on the injury to be treated:

• Hyaluronic acid
• Corticosteroids
• Collagen
• Platelet rich plasma
• orthokine

Hyaluronic acid infiltration

It is a physiological constituent polysaccharide of tissues, it gives rise to the formation of a film that favors tissue repair and healing and has an effect anti-inflammatory and analgesic over the damaged area. It is widely used in rheumatic and traumatic diseases such as arthritis, osteoarthritis and chondropathies.

Infiltration of corticosteroids

For intra-articular infiltration, it is common in monoarticular or inflammatory pathology. soft tissues, when pharmacological and / or rehabilitative treatment are not sufficient or when other treatments are contraindicated.

Platelet-rich plasma infiltration

Consists of the inoculation of autologous platelets (obtained from the patient himself) within the joint. These platelets release growth factors that are involved in tissue regeneration and repair. They are obtained after centrifugation of a blood sample taken from the patient himself. It contains a concentration of platelets higher than that of peripheral blood.

Rest time after infiltration

• Are recommended a few hours of repose and the application of local cold and a oral pain reliever (if necessary).
• Overloading of the infiltrated joint should be avoided and the evolution of the infiltration should be reviewed at 7-10 days.
• If any adverse effect appears, we will consult with the doctor.

Like any medical intervention, it is not without side effects and contraindications, which may appear:

• allergy to the active ingredient
• Local effects (atrophy or erythema)
• Metabolic effects (due to the infiltrated active principle such as hyperglycemia due to corticosteroids).

It may be necessary to perform more than one infiltration to eradicate symptoms,

Sports Medicine Specialist