Knee Injectables in Young Athletes: Evidence, Recommendations, and Clinical Application.

Abstract

Knee pain resulting from acute trauma and overuse injury is common among athletes and represents a major cause of reduced performance, time loss from sport, and long-term sequelae including osteoarthritis. Injectable therapies are frequently used as a nonoperative treatment modality to alleviate symptoms and facilitate early return to sport. This review evaluates the current evidence on commonly used knee injectables in the younger athletic population with pre-arthritic knee pain, including corticosteroids, hyaluronic acid, platelet-rich plasma (PRP), and other biologics. Relevant literature was identified without restriction on study design and with a focus on athlete-specific outcomes and clinical applicability. Overall, the available evidence on knee injectables for athletes remains limited, heterogeneous, and largely extrapolated from older, nonathletic cohorts. In the absence of available athlete-specific guidelines, most injectables carry weak and/or conditional recommendations, highlighting the need for individualized treatment and shared decision-making. High-quality, sport-specific clinical trials are required to establish clear guidelines and optimize outcomes in this population.