More research needed to determine safety of hip and knee steroid injections

October 20, 2020

(Boston)-- Although frequently used to treat painful osteoarthritis of the hip and knee, intra-articular corticosteroid (IACS) injections remain controversial. Questions about whether damage to joints occurs as a result of these injections, which are performed thousands a time each day, persist.

Osteoarthritis of the hip and knee is among the most common joint disorders. A frequently performed treatment for osteoarthritis and other joint related pain syndromes are IACS, yet there is conflicting evidence on their potential benefit and possible negative outcomes following such injections.

"As of today, there is no established recommendation or consensus regarding imaging, clinical, or laboratory markers before an IACS injection is performed to screen for osteoarthritis-related imaging abnormalities and repeating radiographs before each subsequent IACS injection to detect possible adverse joint findings remains controversial," explains corresponding author Ali Guermazi, MD, PhD, chief of radiology at VA Boston Healthcare System and professor of radiology at Boston University School of Medicine (BUSM).

Guermazi and his colleagues had first reported that accelerated arthritis and joint destruction are observed in some patients who received intra-articular corticosteroid injections. (Radiology/2019) https://pubs.rsna.org/doi/10.1148/radiol.2019190341

In this new study, Guermazi led an international expert panel of researchers who reviewed all published evidence in the literature and found not enough evidence exists to decisively draw a conclusion. However, they did recommend the use of imaging for first time injections or multiple injections with the aim of mitigating the risk for joint collapse and total joint replacement. In addition, the panel reviewed the current understanding of pain in osteoarthritis and summarized current international guidelines regarding indications for IACS injection. They also suggested profiles of those who would likely benefit most from IACS injection and recommended updating patient consent forms until further evidence on the topic is available.

The researchers hope that studies with mid- to long-term follow-up will soon be available and provide data from before and after IACS injection compared to appropriate controls. "Understanding the real benefit of IACS in relieving joint pain is paramount," added Guermazi.

These findings appear online in the journal Radiology.
-end-


Boston University School of Medicine

Related Osteoarthritis Articles from Brightsurf:

Major savings possible with app-based osteoarthritis treatment
Osteoarthritis treatment conducted digitally via an app costs around 25% of what conventional care costs, according to a study from Lund University in Sweden published in the research journal PLOS ONE.

New approach to treating osteoarthritis advances
Injections of a natural 'energy' molecule prompted regrowth of almost half of the cartilage lost with aging in knees, a new study in rodents shows.

Bone drug may be beneficial for knee osteoarthritis
Bisphosphonates (a class of drugs that prevent the loss of bone density and used to treat osteoporosis and similar diseases) appear to be safe and beneficial for osteoarthritis patients.

Certain jobs linked to higher risk of knee osteoarthritis
Workers in jobs that typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing face an increased risk of developing knee osteoarthritis.

App helps reduce osteoarthritis pain
By performing a few simple physical exercises daily, and receiving information about their disease regularly, 500 osteoarthritis patients were able to on average halve their pain in 6 months -- and improve their physical function.

Osteoarthritis can increase your risk for social isolation
In a study published in the Journal of the American Geriatrics Society, researchers examined information from the European Project on OSteoArthritis (EPOSA) study.

High rates of opioid prescriptions for osteoarthritis
Opioids work against severe pain but the risks of side effects and addiction are high.

Disease burden in osteoarthritis is similar to rheumatoid arthritis
Osteoarthritis (OA) has traditionally been viewed as a highly prevalent but milder condition when compared with rheumatoid arthritis (RA), and some may believe that it is part of a normal aging process requiring acceptance, not treatment.

3D printing may help treat osteoarthritis
In a Journal of Orthopaedic Research study, scientists used 3D printing to repair bone in the joints of mini-pigs, an advance that may help to treat osteoarthritis in humans.

Finger joint enlargements may be linked to knee osteoarthritis
Heberden's nodes (HNs) are bony enlargements of the finger joints that are readily detectable in a routine physical exam and are considered hallmarks of osteoarthritis.

Read More: Osteoarthritis News and Osteoarthritis Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.