Wednesday, 25 Apr 2018

You are here

Steroid Injections for Knee Osteoarthritis May Promote Cartilage Loss

Treatment of knee osteoarthritis (with synovitis) with an injection of a corticosteroid every three months over two years resulted in significantly greater cartilage volume loss and no significant difference in knee pain compared to patients who received a placebo injection, according to a study published by JAMA.

Symptomatic knee osteoarthritis was estimated to affect more than 9 million individuals in the United States in 2005 and is a leading cause of disability and medical costs. Symptomatic management of knee OA is not thought to promote structural progression or significant cartilage loss.

Timothy E. McAlindon, D.M., M.P.H., of Tufts Medical Center, Boston, and colleagues randomly assigned 140 patients with symptomatic knee osteoarthritis with features of synovitis to injections in the joint with the corticosteroid triamcinolone (n = 70) or saline (n = 70) every 12 weeks for two years. The researchers found that injections with triamcinolone resulted in significantly greater cartilage volume loss than did saline (average change in cartilage thickness of -0.21 mm vs -0.10 mm) and no significant difference on measures of pain. The saline group had three treatment-related adverse events compared with five in the triamcinolone group.

Several limitations of the study are noted in the article, including 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 write.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

USPSTF Recommendations on Vitamin D, Calcium Supplementation to Prevent Fractures

The U.S. Preventive Services Task Force (USPSTF) concludes current scientific evidence is insufficient regarding the use of vitamin D and calcium, alone or in combination, to prevent fractures in men and premenopausal women. The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in postmenopausal women. Current scientific evidence is insufficient regarding the use of vitamin D and calcium at doses greater than 400 IU of vitamin D and greater than 1,000 mg of calcium in postmenopausal women.

Obesity Surgery Tames Knee OA Pain

Laparoscopic gastric band (LAGB) surgery was associated with significant decreases in knee pain from osteoarthritis (OA), with the greatest improvements seen among those whose body mass index (BMI) had the greatest decreases and among younger patients, researchers reported.

NHANES: Trends in Calcium Supplements

The journal Bone reports that given excess calcium intake may not be entirely free from unintended health consequences, it's important to undestand trends in calcium supplement use. 

Chronic Knee Pain Linked to Depression

Chronic pain and depression are intimately linked, but Japanese researchers have found that up to 12% of knee osteoarthritis (OA) may develop depression and that such patients should be screened for depression over time.

Novel Approach to Knee Osteoarthritis Pain

Geniculate artery embolization was found to dampen knee pain arising from osteoarthritis, according to interim study results presented at the 2018 annual meeting of the Society of Interventional Radiology.

One month after the catheter-based procedure, patients reported having less intense knee pain on a visual analog scale (VAS; baseline 75 mm, average decrease of 53 mm, P<0.01).