The Impact of Steroid Injections on Knee Osteoarthritis Progression

Recent research highlights that steroid injections, commonly used for knee osteoarthritis pain relief, may actually accelerate joint deterioration. Osteoarthritis affects hundreds of millions worldwide, with the knee joint being the most commonly impacted. While corticosteroid injections are often administered to reduce inflammation and pain, new evidence indicates they could worsen the underlying structural damage. A study published in Radiology compared the effects of corticosteroid versus hyaluronic acid injections over a two-year period, using advanced MRI techniques to assess joint health.

The study analyzed 210 participants from the Osteoarthritis Initiative, focusing on 70 who received a single intra-articular knee injection—either corticosteroid or hyaluronic acid—and had MRI scans before, at the time of, and two years after the injection. The assessments showed that those receiving corticosteroids experienced greater cartilage loss, development of new bone marrow lesions, and overall structural damage compared to those treated with hyaluronic acid. Conversely, hyaluronic acid injections were associated with reduced joint damage, suggesting they may be a safer long-term option.

Specifically, 44 participants received corticosteroids, and 26 received hyaluronic acid. Results demonstrated that corticosteroid injections led to faster progression of osteoarthritis features, while hyaluronic acid injections appeared to slow or stabilize joint condition. The findings challenge the routine use of corticosteroids for osteoarthritis symptom relief, especially given their potential to impair cartilage repair and promote joint deterioration.

Experts warn that corticosteroids can inhibit cartilage matrix synthesis and weaken the joint's structural integrity over time, possibly leading to increased vulnerability to fractures and further degeneration. This study suggests the need for a reevaluation of treatment protocols, favoring alternatives like hyaluronic acid or other therapies that do not compromise joint health.

Clinicians may consider limiting corticosteroid use and emphasizing treatments that support cartilage preservation. Patient education on the risks associated with corticosteroids is also crucial. These insights could influence future clinical guidelines, advocating for safer, evidence-based approaches to managing knee osteoarthritis and reducing long-term disability.

Source: MedicalXpress