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How a unique long-lasting steroid has helped a Boston-based clinician provide knee OA patients with 3+ months of pain relief


15 million people in the United States suffer from symptomatic knee osteoarthritis (OA), which may include severe stiffness, loss of mobility, and major knee pain on a regular basis. Further, this condition is one of the top causes for disability in older adults. Knee OA impacts everyday activities including walking, using the stairs, bending at the knee, and even sleeping. While this is a chronic, degenerative disease, there are treatment options available to help decrease symptoms and allow those living with knee OA to continue to do the activities they enjoy. 

As a physician assistant at Boston Sports & Shoulder Center specializing in treating orthopedic injuries, I am passionate about offering my patients effective pain management options to provide relief from their knee OA symptoms. In recent years there have been innovations in treating knee pain, including longer-lasting options that provide an alternative to opioids while providing extended pain relief. Even further, research has shown that people taking opioids to manage knee OA pain instead experienced a worsening of symptoms, greater pain, and lower quality of life.

Many of the patients I see who are suffering from knee OA have cycled through several treatment options such as traditional steroid injections and/or hyaluronic acid injections without finding relief. Several years ago, I began using ZILRETTA® (triamcinolone acetonide extended-release injectable suspension), a single-injection, extended-release pain relief treatment that relieves pain from knee OA for three months. ZILRETTA is the first and only FDA-approved treatment for knee OA to use extended-release microsphere technology. These microspheres slowly release medicine over time so that the patient’s pain is continuously managed after a single injection – a differentiator when compared to other injections for knee pain.

In fact, a clinical study found 70% of people had mild to no knee pain for three months after a ZILRETTA treatment – the only injection of its kind to provide that level of extended relief. In addition, this microsphere technology has been very impactful for patients who may be diabetic or pre-diabetic, as traditional steroids have typically been challenging for these patients due to the glucose impact of steroids. ZILRETTA is less likely to cause issues with systemic glucose “spikes” vs. traditional steroids.

Since I began using ZILRETTA, most of my patients have had a substantial reduction in knee pain after just one treatment, including an immense improvement in pain relief when doing day-to-day activities like walking and using stairs. Due to the extended nature of this option, patients are able to go longer in between treatments when compared to traditional steroid injections, which can mean less time attending appointments and more time getting back to the activities they enjoy.

Additionally, the use of ZILRETTA has allowed me to reduce the number of opioids prescribed to patients for chronic knee pain due to OA. With research finding that, over the past three decades, the use of opioids for the treatment of OA pain has increased, being able to minimize the need for these risky medications is an added benefit for patients. 

About 45% of people will develop knee OA in their lifetime, so it’s important for patients to understand the range of treatment options available to them. It’s exciting to see innovations like the microsphere technology of ZILRETTA that continue to provide patients with effective pain management. I encourage anyone living with knee OA to talk to their physicians about pain management and how they can find long-term relief, especially if their current regimen is not satisfactory. Knee pain can be debilitating, but extended pain relief is possible. Patients should be able to advocate for their well-being, and it’s important for them to know that extended pain management treatments, such as ZILRETTA, are available. 

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ZILRETTA® (triamcinolone acetonide extended-release injectable suspension) is an extended-release corticosteroid approved to manage osteoarthritis knee pain. The benefits and risks of repeat injections have not been demonstrated.

You should not receive a ZILRETTA injection if you are allergic to corticosteroids, triamcinolone acetonide, or any other component of the product.

Important Safety Information

Rare serious allergic reactions:

  • Effects in the injected knee such as infection (with pain, swelling and restricted motion) or joint damage
  • Increased chance of getting an infection, and a decreased ability to fight an infection
  • Effects on hormone production. These effects can be reversible
  • Elevated blood pressure, sodium and water retention, and potassium loss
  • Intestinal perforation if you have certain gastrointestinal disorders
  • Weakening of bones
  • Changes in behavior or mood disturbances
  • Increased pressure inside the eye

In multiple clinical trials, the most common side effects seen in people taking ZILRETTA were joint pain, headache, joint swelling, back pain, sore throat and runny nose, upper respiratory tract infection, and bruising.

Tell your doctor about all of the medications you are taking (including both prescription and over-the-counter medicines) and about any medical conditions, especially if you have high blood pressure, heart disease, ulcers, diverticulitis or other gastrointestinal disorders, kidney problems, diabetes, glaucoma, behavior or mood disorders, and/or infections.

Contact your doctor if you develop a fever or other signs of infection, have an increase in pain along with swelling of the injected knee, restriction of joint motion, or a general feeling of discomfort. Contact your doctor immediately if you are exposed to chicken pox or measles, or for any new or worsening changes in behavior or mood.

These are not all of the possible side effects with ZILRETTA or corticosteroid medications. Please see the full Prescribing Information at Always contact your doctor if you have questions or experience any side effects.

To report SUSPECTED ADVERSE REACTIONS, contact Pacira Pharmaceuticals, Inc. at 1-844-353-9466 or FDA at 1-800-FDA-1088 or