Steroid Shots No Long-Term Help in Knee OA
Written by Editor   
Wednesday, February 17, 2016 12:00 AM

Knee Joint injections do not prevent structural damage in osteoarthritic knees.

Intra-articular steroid injections are not effective over the long term for preventing structural damage in knee osteoarthritis, a 2-year randomized trial found.  In the study, which was funded by the National Institutes of Health, there were no significant differences between patients who received injections of triamcinolone hexacetonide every 12 weeks and those given placebo.

It's now known that some degree of inflammation is present in the joint in osteoarthritis, and studies have suggested that the inflammation seems to predict structural progression, which raises the possibility that an intervention that reduces inflammation might delay the progression.

The study included 140 patients, with slightly more than half being women. A third were nonwhite, and mean body mass index was 31.2 kg/m2.  Participants had injections of 40 g triamcinolone or saline every 12 weeks, for a total of eight injections.

MRI cartilage damage was assessed using the validated quantitative CDI, which focuses on the regions of the joint that are most liable to damage. The area of denudation also was evaluated, and a semiquantitative feature score rated fissures, delamination, superficial fibrillation, and signal change.

The only structural endpoint other than the CDI that differed between the two groups was in the progression of superficial fibrillation, with more changes being seen in the placebo group. No differences were seen in total cartilage denudation, subchondral bone, or effusion volume.