Steroid Injections Accelerate Damage To Joint Surfaces

Picture from Ortho Arizona

Many patients with knee osteoarthritis (OA) who come to see us in our clinics often tell us that they were given intra articular (inside the joint) corticosteroid injections (IACS). ICAS is a common treatment choice that is considered minimally invasive to delay knee replacements for patients with severe OA. 

Other than providing brief pain relief, the pain often comes back. I wrote earlier this year that steroid/ cortisone injections significantly increases the risk of tendon tears.

Perhaps it's time to think more than twice before you allow anyone to inject into you knee joint. Make it any other joint for that matter as latest published research shows that individuals who got IACS were twice as likely to have harmful effects on knee articular cartilage structure than those who received no or placebo treatment.

Different stages of articular cartilage damage

A group of researchers investigated the effect of IACS on articular cartilage structure in patients with knee OA using joint space width on x-ray and articular cartilage thickness with MRI.

They found 6 studies consisting of a total pf 1437 participants. The estimated effect of IACS on articular cartilage structure showed significant odds of it worsening as measured by joint space narrowing and articular cartilage thickness. The authors concluded that their meta- analysis showed that IACS increases the likelihood of knee joint deterioration.

Other than increasing the risk of tendon tears, steroid/ cortisone  injections into knee joints may be doing more harm than good by accelerating joint surfaces degeneration. The short lasting pain relief is definitely not worth the long term consequences of your articular cartilage degenerating. 

Reference

Ibad HA, Kasaeian A, Ghotbi G et al (2023). Longitudinal MRI-defined Cartilage Loss And Radiographic Joint Space Narrowing Following Intra-articular Corticosteroid Injection For Knee Osteoarthritis: A Systematic Review And Meta-analysis. Osteo Imaging. DOI: 10.1016/j.ostima.2023.100157