Skip to main content
NCBI home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1996 Nov;55(11):829–832. doi: 10.1136/ard.55.11.829

Intra-articular corticosteroids are effective in osteoarthritis but there are no clinical predictors of response.

A Jones 1, M Doherty 1
PMCID: PMC1010319  PMID: 8976640

Abstract

OBJECTIVES: To show whether intra-articular steroid injections are effective in osteoarthritis; to determine factors that predict response; and to determine whether injection has a beneficial effect on muscle strength. METHODS: Double blind, placebo controlled, crossover study in 59 patients with symptomatic osteoarthritis of the knee. Outcome measure-Primary outcome measure: change in visual analogue score for pain at three weeks. Predictors of response analysed using logistic regression with a 15% decrease in pain score at three weeks defining response. RESULTS: Intra-articular methyl prednisolone acetate produced a significant reduction in visual analogue pain score at three weeks compared to both baseline (median change -2.0 mm, interquartile range -16.25 to 4.0) and placebo (median 0.0 mm, interquartile range -9.0 to 6.25). No clinical predictors of response could be identified. Muscle strength was not significantly improved in the short term by intra-articular injection. CONCLUSIONS: Intra-articular corticosteroids are effective for short term relief of pain in osteoarthritis but predicting responders is not possible. There may be a place for their more widespread use.

Full text

PDF
829

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altman R., Asch E., Bloch D., Bole G., Borenstein D., Brandt K., Christy W., Cooke T. D., Greenwald R., Hochberg M. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986 Aug;29(8):1039–1049. doi: 10.1002/art.1780290816. [DOI] [PubMed] [Google Scholar]
  2. Bradley J. D., Brandt K. D., Katz B. P., Kalasinski L. A., Ryan S. I. Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol. 1992 Dec;19(12):1950–1954. [PubMed] [Google Scholar]
  3. Dieppe P. A., Sathapatayavongs B., Jones H. E., Bacon P. A., Ring E. F. Intra-articular steroids in osteoarthritis. Rheumatol Rehabil. 1980 Nov;19(4):212–217. doi: 10.1093/rheumatology/19.4.212. [DOI] [PubMed] [Google Scholar]
  4. Edwards R. H., Young A., Hosking G. P., Jones D. A. Human skeletal muscle function: description of tests and normal values. Clin Sci Mol Med. 1977 Mar;52(3):283–290. doi: 10.1042/cs0520283. [DOI] [PubMed] [Google Scholar]
  5. Fahrer H., Rentsch H. U., Gerber N. J., Beyeler C., Hess C. W., Grünig B. Knee effusion and reflex inhibition of the quadriceps. A bar to effective retraining. J Bone Joint Surg Br. 1988 Aug;70(4):635–638. doi: 10.1302/0301-620X.70B4.3403614. [DOI] [PubMed] [Google Scholar]
  6. Friedman D. M., Moore M. E. The efficacy of intraarticular steroids in osteoarthritis: a double-blind study. J Rheumatol. 1980 Nov-Dec;7(6):850–856. [PubMed] [Google Scholar]
  7. Gaffney K., Ledingham J., Perry J. D. Intra-articular triamcinolone hexacetonide in knee osteoarthritis: factors influencing the clinical response. Ann Rheum Dis. 1995 May;54(5):379–381. doi: 10.1136/ard.54.5.379. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Geborek P., Månsson B., Wollheim F. A., Moritz U. Intraarticular corticosteroid injection into rheumatoid arthritis knees improves extensor muscles strength. Rheumatol Int. 1990;9(6):265–270. doi: 10.1007/BF00541322. [DOI] [PubMed] [Google Scholar]
  9. Hurley M. V., Newham D. J. The influence of arthrogenous muscle inhibition on quadriceps rehabilitation of patients with early, unilateral osteoarthritic knees. Br J Rheumatol. 1993 Feb;32(2):127–131. doi: 10.1093/rheumatology/32.2.127. [DOI] [PubMed] [Google Scholar]
  10. Jones A., Hopkinson N., Pattrick M., Berman P., Doherty M. Evaluation of a method for clinically assessing osteoarthritis of the knee. Ann Rheum Dis. 1992 Feb;51(2):243–245. doi: 10.1136/ard.51.2.243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Jones A., Regan M., Ledingham J., Pattrick M., Manhire A., Doherty M. Importance of placement of intra-articular steroid injections. BMJ. 1993 Nov 20;307(6915):1329–1330. doi: 10.1136/bmj.307.6915.1329. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jones D. W., Jones D. A., Newham D. J. Chronic knee effusion and aspiration: the effect on quadriceps inhibition. Br J Rheumatol. 1987 Oct;26(5):370–374. doi: 10.1093/rheumatology/26.5.370. [DOI] [PubMed] [Google Scholar]
  13. Kirwan J. R., Reeback J. S. Stanford Health Assessment Questionnaire modified to assess disability in British patients with rheumatoid arthritis. Br J Rheumatol. 1986 May;25(2):206–209. doi: 10.1093/rheumatology/25.2.206. [DOI] [PubMed] [Google Scholar]
  14. McAlindon T. E., Cooper C., Kirwan J. R., Dieppe P. A. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 1993 Apr;52(4):258–262. doi: 10.1136/ard.52.4.258. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sparling M., Malleson P., Wood B., Petty R. Radiographic followup of joints injected with triamcinolone hexacetonide for the management of childhood arthritis. Arthritis Rheum. 1990 Jun;33(6):821–826. doi: 10.1002/art.1780330608. [DOI] [PubMed] [Google Scholar]
  16. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES