More research needed to determine safety of hip and knee steroid injections

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Although commonly used to treat painful osteoarthritis of the hip and knee, intra-articular corticosteroid injections (IACS) remain controversial. Questions remain as to whether these injections, which are performed thousands of times a day, cause joint damage.

Osteoarthritis of the hip and knee is one of the most common joint diseases. A frequently performed treatment for osteoarthritis and other joint-related pain syndromes is the IACS. However, there is conflicting evidence as to their potential benefits and possible negative outcomes after such injections.

“To date, there is no established recommendation or consensus on imaging, clinical, or laboratory markers before giving an IACS injection to check for osteoarthritis-related imaging disorders and taking x-rays before each subsequent IACS injection to detect possible adverse joint findings recognize remains controversial “, explains the author Dr. Ali Guermazi, Chief Radiologist at VA Boston Healthcare System and Professor of Radiology at Boston University School of Medicine (BUSM).

Guermazi and his colleagues had first reported that accelerated arthritis and joint destruction were observed in some patients who received intra-articular corticosteroid injections. (Radiology, 2019)

In this new study, Guermazi chaired an international panel of experts who reviewed all published evidence in the literature and found that there wasn’t enough evidence to reach a final conclusion. However, they recommended the use of imaging for primary or multiple injections with the aim of reducing the risk of joint collapse and total joint replacement. In addition, the panel reviewed the current understanding of pain associated with osteoarthritis and summarized the current international guidelines on indications for IACS injection. They also suggested profiles of those likely to benefit most from the IACS injection and recommended updating patient informed consent pending further evidence on the matter.

The researchers hope that medium to long-term follow-up studies will soon be available that will provide data before and after the IACS injection compared to appropriate controls. “Understanding the real benefits of IACS in relieving joint pain is of paramount importance,” added Guermazi.

These results appear online in the journal Radiology.

New evidence that steroid injections from the hip and knee can damage the joints. Provided by Boston University School of Medicine

Quote: Further studies to determine the safety of hip and knee steroid injections (2020, October 20) were published on October 20, 2020 at https://medicalxpress.com/news/2020-10-safety-hip-knee- steroid.html

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