Steroid injections do not hasten the need for knee replacement says new research

Corticosteroid injections in the knees of people with arthritis do not accelerate a patient’s progression to a total knee replacement when compared with hyaluronic acid injections, researchers outlined at a recent rheumatology conference.

Some studies have suggested that steroid injections result in a threefold-higher risk of progression to surgery for people with knee osteoarthritis. But this could be because many people in studies of corticosteroid therapy have more advanced knee arthritis.

So to clarify the potential risks of steroid injections for knee osteoarthritis progression, a team compared steroid injections to hyaluronic acid injections (which are not associated with cartilage loss).

The team looked at two large studies of people with knee osteoarthritis who received injections of corticosteroid (647 knees) or hyaluronic acid (145 knees). They reviewed the rates of joint damage seen on X-rays and total knee replacement surgery.

Results suggest that corticosteroid injections are not associated with higher risk of key signs of worsening knee osteoarthritis: joint damage or progression to knee replacement surgery, when  compared to hyaluronic acid injections.

“We did not find any association between steroid injections and worsening knee osteoarthritis in our study,” highlights Dr Justin Bucci. “Patients and clinicians should see this study and feel reassured that these injections are not causing progression of osteoarthritis or earlier total knee replacement.”

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