Table 2.

The role of corticosteroids in the management of patients with knee osteoarthritis.

Author	Journal and year of publication	Type of study	Total number of patient	Study groups	Key finding(s)
Tian et al.	Medicine (Baltimore) 2018	Systematic review and meta-analysis	739	Methylprednisolone vs. placebo (intra-articular injection)	Significant improvement using methylprednisolone compared to placebo with respect to WOMAC (Western Ontario and McMaster Universities Arthritis Index) pain scores and physical function at 4, 12, and 24 weeks
Juni et al.	Cochrane Database of Systematic Reviews 2015	Meta-analysis	1,767	Any type of intra-articular corticosteroid vs. sham intra-articular corticosteroid and no intervention	Steroids were superior to control in terms of pain score reduction (1.0 cm VAS scale difference) as well as more effective function improvement (a difference of −0.7 units on WOMAC disability scale)
Kraus et al.	Osteoarthritis Cartilage 2018	Phase 2 open-label study	81	Single intra-articular injection of extended-release, microsphere-based formulation of triamcinolone acetonide (TA) (FX006) vs. crystalline suspension (TAcs)	Microsphere-based TA injections resulted in prolonged synovial fluid joint concentration, diminished peak plasma levels, and reduced systemic TA exposure when compared to TAcs
Conaghan et al.	The Journal of Bone and Joint Surgery 2018	Phase 3, multicenter, double-blinded study	484	Intra-articular injections of FX006 vs. TAcs vs. saline-solution placebo	FX006 was better than placebo with respect to significant improvement (∼50%) in average-daily-pain (ADP)-intensity from baseline to week 12
Hangody et al.	Cartilage 2018	Multicenter, double-blind clinical trial	368	Intra-articular injections of Monovisc (hyaluronic acid) vs. Cingal (hyaluronic acid plus triamcinolone hexacetonide) vs. saline	Clinical improvement from baseline was significantly greater compared to saline through 12 and 26 weeks. At 1 and 3 weeks, Cingal was significantly better than Monovisc for most endpoints, however, there was no difference between the two treatment modalities from 6 weeks through 26 weeks
Campbell et al.	Arthroscopy 2015	Meta-analyses	3,230	Intra-articular platelet-rich plasma (IA-PRP) vs. control (intra-articular hyaluronic acid or intra-articular placebo)	PRP resulted in significant improvements in patient outcomes at 2 months through 12 months after injection. Patients with less radiographic evidence benefited more with PRP treatment. IA-PRP injection led to significant improvements in patient outcomes (WOMAC score, IKDC score, Lequesne index) and led to greater increases in the pooled effect size versus treatment with control (HA or NS) at 6 months after injection
He et al.	International Journal of Surgery 2017	Meta-analysis	1,794	Intra-articular hyaluronic acid and intra-articular corticosteroids	Patients taking steroids had better VAS pain scores up to 1 month after injection compared to patients taking hyaluronic acid; however, at 6 months the reverse was true. With respect to WOMAC score at 6 months the hyaluronic acid group showed greater relative effect

HA, hyaluronic acid; IKDC, International Knee Documentation Committee; NS, normal saline; VAS, visual analog scale.