Failed Knee or Shoulder Arthroplasty? – Intra-articular Botox Injections Help

50% reduction of pain was reported in about 1/2 of post shoulder and knee arthroplasty pain cases with Botox injections. This was sustained by repeated injections.

Br J Med Med Res. 2014 Jan;4(1).
Efficacy of Long-term Effect and Repeat Intraarticular Botulinum toxin in Patients with Painful Total Joint Arthroplasty: A Retrospective Study.
Singh JA.
(can download article from there)

  • moderate to severe refractory prosthetic joint pain
  • ruled out implant infection, loosening or any surgically explainable cause of pain
  • used 100 – 300 u Botox in 5 mls saline
  • Confirmed joint penetration by ability to aspirate joint fluid

  • average 3 shots
  • if failed at 100 units worked up to 200-300
  • average 3 injections over average 1 year followup.
  • at 3 -4 months after injection, 57% patients reported 50% reduction in daytime pain

Comment – that, combine with work on retinaculum and muscles, should deal with post knee issues. Have not seen failed shoulder arthropjasty recently.

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