Findings Do Not Support Steroid Injections for Knee Osteoarthritis

CHICAGO -- May 16, 2017 -- Among patients with knee osteoarthritis, an injection of a corticosteroid every 3 months over 2 years resulted in significantly greater cartilage volume loss and no significant difference in knee pain compared with patients who received a placebo injection, according to a study published by JAMA.

Treatments for osteoarthritis are primarily prescribed to reduce symptoms, with no interventions known to influence structural progression. Synovitis is common and is associated with progression of structural characteristics of knee osteoarthritis. Intra-articular corticosteroids could reduce cartilage damage associated with synovitis but might have adverse effects on cartilage and bone.

Timothy E. McAlindon, Tufts Medical Center, Boston, Massachusetts, and colleagues randomised 140 patients with symptomatic knee osteoarthritis with features of synovitis to injections in the joint with triamcinolone (n = 70) or saline (n = 70) every 12 weeks for 2 years.

The researchers found that injections with triamcinolone resulted in significantly greater cartilage volume loss than did saline (mean change in cartilage thickness of -0.21 mm vs -0.10 mm) and no significant difference on measures of pain.

The saline group had 3 treatment-related adverse events compared with 5 in the triamcinolone group.

A limitation of the study was that any transient benefit on pain ending within the 3-month period between each injection could have been missed by methods used in the study.

“These findings do not support this treatment for patients with symptomatic knee osteoarthritis,” the authors wrote.

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