Corticosteroid injection may increase medial joint space narrowing, progression of knee OA

Darbandi A, et al. Medial joint space narrowing and Kellgren-Lawrence progression following intra-articular corticosteroid injections compared to hyaluronic acid injections and nontreated patients. Presented at: Radiological Society of North America Annual Meeting; Nov. 27-Dec. 1, 2022; Chicago.

Darbandi A, et al. Medial joint space narrowing and Kellgren-Lawrence progression following intra-articular corticosteroid injections compared to hyaluronic acid injections and nontreated patients. Presented at: Radiological Society of North America Annual Meeting; Nov. 27-Dec. 1, 2022; Chicago.

Results showed patients who received corticosteroid injections had increased medial joint space narrowing and progression of knee osteoarthritis compared with patients who received hyaluronic acid injections.

"Further research should be done investigating the possible impact of [corticosteroid injections] on osteoarthritis progression," Azad Darbandi, researcher and medical student at Chicago Medical School at Rosalind Franklin University of Medicine and Science, told Healio about results presented at the Radiological Society of North America Annual Meeting. "In addition, further research should be done investigating the benefits of [hyaluronic acid] HA injections for symptomatic management in patients with osteoarthritis."

Darbandi and colleagues identified 210 knees with OA that received corticosteroid injections, 59 knees that received HA injections and 6,827 knees in the control group. Researchers matched 50 patients per group for age, sex, BMI, comorbidities, surgery and semi-quantitative imaging outcomes at baseline. Researchers collected imaging outcomes, including joint space narrowing, Kellgren-Lawrence grade, osteophyte formation in the tibia/femur medial/lateral compartment and sclerosis in the tibia/femur medial/lateral compartment.

At 48 months, results showed patients in the corticosteroid group had increased Kellgren-Lawrence progression of knee OA compared with the HA group and control group. Researchers also found the corticosteroid group had increased medial joint space narrowing vs. the control group.

"The results suggested that corticosteroid injections accelerated the radiographic progression of osteoarthritis, specifically medial joint space narrowing and Kellgren-Lawrence grading, whereas hyaluronic acid injections did not," Darbandi said. "It is important to note that radiographic progression does not always correlate to clinical progression; however, the results suggest that further investigation regarding the effect of intra-articular injections would be beneficial."