69 year old woman who is active and trains regularly has had a swollen knee (it is difficult to see the border of her kneecap) with a restricted range of motion for a few months. A sports medicine doctor examined the knee and an x-ray and diagnosed the issues as early osteoarthritis and irritated degenerative knee. He thought something might have triggered this. Recently, swelling has been going down and ROM has been improving, so he recommended no treatment other than continuing to train, walk, etc. If it gets worse, he recommended coming back for platelet and other injections.
FWIW, she chose this doctor because he’s a big fan of exercise.
From what I read, the American College of Rheumatology and the Arthritis Foundation recommend against platelet-rich plasma (presumably that’s what he meant by a platelet injection), but more research is needed.
Are there injections that are actually useful? Any other treatment beyond training to tolerance?
It is typically for short/medium-term symptomatic relief, yes.
For ongoing long-term use (for example, repeat injections every few months indefinitely) there is likely some harm with respect to articular cartilage.
It sounds like the long-term solution is physical activity, including squats, so long as they don’t aggravate the knee (pain, swelling, decreased ROM). Which sounds like the solution for so many things.