Intra-articular corticosteroid injections are a long-established treatment for knee osteoarthritis (OA), but new findings indicate they are not effective, and even potentially harmful. Is it time to rethink the use of this treatment?
This is a preview of subscription content
Access options
Subscribe to Nature+
Get immediate online access to the entire Nature family of 50+ journals
$29.99
monthly
Subscribe to Journal
Get full journal access for 1 year
$59.00
only $4.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Buy article
Get time limited or full article access on ReadCube.
$32.00
All prices are NET prices.
References
Hollander, J. L., Brown, E. M. Jr., Jessar, R. A. & Brown, C. Y. Hydrocortisone and cortisone injected into arthritic joints: comparative effects of and use of hydrocortisone as a local antiarthritic agent. J. Am. Med. Assoc. 147, 1629–1635 (1951).
Hochberg, M. C. et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res. (Hoboken) 64, 455–474 (2012).
da Costa, B. R. et al. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. Lancet https://doi.org/10.1016/S0140-6736(17)31744-0 (2017).
Boesen, M. et al. Osteoarthritis year in review 2016: imaging. Osteoarthritis Cartilage 25, 216–226 (2017).
Bar-Or, D., Rael, L. T. & Brody, E. N. Use of saline as a placebo in intra-articular injections in osteoarthritis: potential contributions to nociceptive pain relief. Open Rheumatol. J. 11, 16–22 (2017).
Bannuru, R. R. et al. Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis. Ann. Intern. Med. 162, 46–54 (2015).
Pelletier, J. P. et al. Intraarticular injections with methylprednisolone acetate reduce osteoarthritic lesions in parallel with chondrocyte stromelysin synthesis in experimental osteoarthritis. Arthritis Rheum. 37, 414–423 (1994).
Juni, P. et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst. Rev. 10, CD005328 (2015).
Henriksen, M. et al. Evaluation of the benefit of corticosteroid injection before exercise therapy in patients with osteoarthritis of the knee: a randomized clinical trial. JAMA Intern. Med. 175, 923–930 (2015).
Raynauld, J. P. et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 48, 370–377 (2003).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Bliddal, H., Henriksen, M. Time to put steroid injections behind us?. Nat Rev Rheumatol 13, 519–520 (2017). https://doi.org/10.1038/nrrheum.2017.118
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrrheum.2017.118
Further reading
-
Differences in 1‑year outcome after primary total hip and knee arthroplasty
Der Orthopäde (2019)