Corticosteroid injections for osteoarthritis of the knee

This fact box will help you to weigh the benefits and harms of corticosteroid injections for osteoarthritis of the knee. The information and numbers are based on the best scientific evidence currently available.

This fact box was developed by the Harding Center for Risk Literacy.

What is osteoarthritis of the knee?

Osteoarthritis is a degenerative disease due to wear and tear of the joints cartilage. Many different factors, such as obesity and strain on the joints, can lead to osteoarthritis of the knee (gonarthrosis). However, the cause is not always clear. At an advanced stage of the disease, joint cartilage and other structures within the joint deteriorate. Consequently, joint pain and stiffness may occur [1].

What are corticosteroid injections?

Corticosteroids are designed to have anti-inflammatory effects, reduce swelling, and alleviate pain.To treat osteoarthritis of the knee, corticosteroids (e.g. triamcinolone, hydrocortisone, or methylprednisolone)are injected directly into the impaired knee (“intra-articular”) [1].

Who might consider corticosteroid injections?

Adults who suffer from osteoarthritis of the knee can consider corticosteroid injections.

What are the alternative treatment options?

Alternative treatment options include physical therapy, treatment with painkillers, and joint replacement surgery.

Fact box corticosteroid injections for osteoarthritis of the knee
Fact box corticosteroid injections for osteoarthritis of the knee © Harding Center for Risk Literacy
What does the fact box show?

The fact box shows the benefits and harms of corticosteroid injections compared to placebo injections for people with osteoarthritis of the knee.

The table may be read as follows:

310 out of every 1,000 people who received a placebo injection experienced a reduction in pain; 440 out of every 1,000 people who received a corticosteroid injection reported a reduction in pain.

The numbers in the fact box are rounded. They are based on 27 studies with about 1,800 participants [1].

What other aspects should be considered?

Participants were asked to rate the reduction in pain and improvement in function of the knee joint on a scale from 0 to 10, where 0 stands for pain and no impaired function and 10 for severe pain and severely limited mobility.

After one month, people who received a corticosteroid injection reported a reduction in pain by 3 points on the scale, and people who received a placebo injection reported an improvement by 2 points.

As for function of the knee joint, people who received a corticosteroid injection reported an improvement by 2 points, and people who received a placebo injection reported an improvement by 1 point after one month [1].

Do the results provide proof (evidence) for the benefits and harms of corticosteroid injections?

Overall, the evidence is of low quality. Benefits may be overestimated. In addition, the results of the individual studies are contradictory. It is very likely that further research will change the results [1].

Version history of the fact box
  • July 2016 (last update)
Sources

Information within the fact box was obtained from the following source:

[1] Jüni P, Hari R, Rutjes AWS, et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst Rev 2015(10) doi: 10.1002/14651858.CD005328.pub3.