The effectiveness of corticosteroid injections, a treatment to relieve pain associated with knee osteoarthritis, is called into question by a study. Researchers believe that they could advance the disease.
- 10 million people suffer from osteoarthritis in France, according to Inserm.
- When the medicinal solutions no longer allow to relieve the osteoarthritis of the knee, the installation of a knee prosthesis is considered.
3% of the population under 45 suffer from osteoarthritis in France, according to’Health Insurance. Among those over 65, this represents 65% and 80% over 80. This disease can be defined as the destruction of cartilage – which allows bones to slide over each other – of one or more joints.
Knee osteoarthritis: do injections really relieve pain?
When this pathology affects the knee, it is the bone ends of the joint, covered with cartilage, which are affected. For the moment, no treatment can cure this pathology but, to slow down its evolution, doctors generally recommend that patients follow lifestyle and dietary measures.
Medication anti-inflammatories and analgesics may also be prescribed to relieve pain. When these are no longer sufficient, doctors may recommend corticosteroid injections. But these would not be effective, according to two new studies presented at the annual congress of the North American Society of Radiology, the Radiological Society of North America (RSNA). Worse, the researchers even believe that they could make the disease progress.
In the first study, scientists followed 210 participants for two years. Among them, 44 received corticosteroid injections, 26 hyaluronic acid injections and 140 had no injections because they were part of the control group.
Corticosteroid injections worsen knee osteoarthritis
To analyze the impact of the treatment on the patients, the researchers compared the MRIs taken two years before, during and two years after the injections. Results: those of corticosteroids were associated with progression of knee osteoarthritis. On the other hand, those of hyaluronic acid were not associated with an aggravation of this disease. On the contrary, there was rather a slowing down compared to the control group having had no injections.
“This is the first direct comparison of corticosteroid and hyaluronic acid injections using semi-quantitative assessment of the whole knee organ by MRI”, Dr. Upasana Upadhyay Bharadwaj pointed out, researcher in the Department of Radiology at the University of California.
In the second study, scientists compared the progression of osteoarthritis over three years in 150 patients: 50 received corticosteroid injections, 50 hyaluronic acid and 50 others received nothing. This time, the follow-up was done by X-ray radiography. Here too, the results show that people who received corticosteroid injections had an increase in their knee osteoarthritis.
Nevertheless, the researchers indicate that their results should be taken “with caution” and recommend to perhaps reconsider the injections of hyaluronic acid, which are currently no longer reimbursed by health insurance.
