Steroid injections used to treat knee arthritis can make the condition worse, a study suggests.
Researchers from the University named after CaliforniaSan Francisco (UCSF) and Chicago The medical school collected data from hundreds during two studies osteoarthritis patients to assess how their condition will respond to the shots.
Between the two studies, 94 patients who received corticosteroids — anti-inflammatory drugs used to treat a variety of conditions — saw their condition worsen.
Those who received injections of hyaluronic acid, a natural substance that lubricates joints, saw a slow progression of their condition.
Previous research suggests that corticosteroids can damage the cartilage in the joint and make it more susceptible to wear and tear, causing patients to need hip or knee replacements.
More than 32.5 million adults in the United States have knee arthritis, with approximately 80 percent of adults over the age of 55 showing signs of the disease.
More than one in ten of these patients choose corticosteroid or hyaluronic acid injections to relieve pain.
Shown above is the knee joint of a patient with arthritis (left), with arrows showing where the cartilage is worn away. The second (right) shows a patient who does not have arthritis
In the first study – will be presented on Monday at Radiological Society of North America — researchers from California analyzed data for two years for 210 patients with knee arthrosis.
More than half of the group – 140 people – did not receive injections during this time.
Among the rest, 44 received corticosteroid injections, and 26 received hyaluronic acid.
WHAT IS OSTEOARTHRITIS?
Osteoarthritis – sometimes called “wear and tear” – is a disease that occurs when the joint surfaces are damaged.
The cartilage that covers the ends of bones gradually thins over time and the bone thickens, Versus Arthritis reports.
Around a third of people aged 45 and over in the UK have the condition. This is approximately 8.75 million people. It is known that at least 20 million were affected in the USA.
This is different from rheumatoid arthritis, a long-term disease in which the immune system causes the body to attack itself, causing painful, swollen and stiff joints.
Joint replacement is often necessary for osteoarthritis patients because the joint has worn down and is causing excruciating pain.
Corticosteroids reduce the activity of white blood cells and prevent the immune system from causing painful inflammation.
Hyaluronic acid is naturally found in human eye and joint fluid.
It acts as a lubricant for the joints, helping to reduce pain when using them.
They were all matched for age, sex, body mass index, pain and physical activity scores, and disease severity.
MRI was done two years before treatment, during treatment, and two years later to assess the progression of arthritis.
The analysis showed that those who received corticosteroid injections progressed arthritis significantly faster compared to the other groups.
The group treated with hyaluronic acid, however, showed a reduction in the progression of osteoarthritis compared to those who did not receive any treatment.
Dr. Upasana Upadhyay Bharadwaj, a radiologist at UCSF who led the study, said: “Although corticosteroid and hyaluronic acid injections have been reported to help relieve symptomatic knee osteoarthritis pain, our results strongly suggest that corticosteroids are associated with significant progression of knee osteoarthritis joint. up to two years after the injection and should be administered with caution.
“On the other hand, hyaluronic acid can slow the progression of knee osteoarthritis and mitigate long-term effects while providing symptom relief.”
He added that this was the first study to directly compare two treatments using these types of MRIs.
In the second study, researchers from Chicago analyzed data on 150 patients who were followed for 36 months.
The group was evenly divided into people who received no injections, hyaluronic acid injections, and corticosteroid injections. They were also matched for sex, body mass index, and X-rays.
The patients underwent X-rays at the time of the injections and after two years, each of which was assessed for disease progression.
The results showed that those who received corticosteroid injections had a significantly greater rate of osteoporosis progression after two years.
But those who received hyaluronic acid injections or no treatment did not have such rapid deterioration.
Azard Darbandi, a medical student from Chicago who led the study, said: “Visual signs of osteoarthritis were worse after two years in patients who received corticosteroid injections compared to patients who received hyaluronic acid injections or no treatment.
“The results suggest that hyaluronic acid injections should be further studied for the management of knee osteoarthritis symptoms, and that steroid injections should be used with more caution.”
Patients may choose to have corticosteroid injections in the knee to provide short-term relief from arthritis pain.
But in the long term, these studies show that they can actually cause joints to deteriorate more quickly, causing more pain.
Participants were recruited from the Osteoarthritis Initiative, an observational study of nearly 5,000 patients. He is already 14 years old.