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Steroid injections for knee arthritis ‘acceptable for short-term management’

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Are cortisone injections a valid treatment option for knee osteoarthritis (OA)?

Earlier this year, a study suggested that patients with symptomatic knee OA get no long-term pain relief from intra-articular corticosteroid injections. What’s more, the treatment was associated with a small amount of cartilage loss over a two-year period.

But a new study published in the October issue of the Journal of the American Academy of Orthopaedic Surgeons concludes that intra-articular corticosteroid injections may be an acceptable short-term management option, providing effective relief and improving function for patients who are not ready or able to undergo surgical treatment.

“Patients with symptomatic knee OA who received an intra-articular corticosteroid injection demonstrated improvement in pain, stiffness and function for up to six months,” said Dr Elizabeth Matzkin, an orthopaedic surgeon specialising in sports medicine with Brigham and Women’s Hospital.

The study authors also noted, however, that less improvement is seen in patients with obesity and/or advanced arthritis.

The multi-centre study involved 100 participants with radiographic evidence of knee OA.

While knee OA is complex and often secondary to many other factors, Dr Matzkin highlighted the factors that patients can control to help prevent and minimise the symptoms of the disease:

– Maintaining a healthy body weight and diet. Every pound of weight can feel like 5 pounds to the knee, which is a risk factor for knee OA. However, this also means that a 20-pound weight loss can feel like 100-pound weight loss to the knee, significantly decreasing the load on the joint and improving pain.

– Participating in physical activity to help keep muscles strong. Keeping the proximal knee muscles (the muscles near the knee joint) strong can help decrease the symptoms of knee OA. These muscles include the hip flexors that help move your leg or knee up towards your torso, abductors (outer thigh) and quadriceps (front of the thigh).

http://newsroom.aaos.org/media-resources/Press-releases/weighing-nonsurgical-treatment-options-for-knee-osteoarthritis-pain.htm

http://journals.lww.com/jaaos/Abstract/2017/10000/Efficacy_and_Treatment_Response_of_Intra_articular.5.aspx