Intra-articular corticosteroid injections provide short-term pain reduction in knee OA

Study Type: Meta analysis
OE Level of Evidence: 2
Journal Level of Evidence: N/A
Five randomized controlled trials were included in this meta-analysis to evaluate the efficacy of intra-articular corticosteroid injections compared to placebo in patients with knee osteoarthritis. The outcomes of interest that were pooled using meta-analysis were a failure to reach a target pain outcome and pain scores on a visual analog scale (VAS). Significantly fewer patients Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Not Reported
Conflicts: None disclosed
Why was this study needed now?
Knee osteoarthritis is a prevalent condition in the adult population that is expected to place an increasingly large burden on the healthcare system as the population ages. There are a number of conservative treatments commonly used in the management of this condition that do not have strong evidence supporting their use. A synthesis of randomized controlled trials evaluating the use of corticosteroid injections in the management of knee osteoarthritis was needed to provide the best estimate of efficacy via meta-analysis.
What was the principal research question?
Does the use of an intra-articular corticosteroid injection reduce pain, without increasing adverse events, when compared to placebo injections in patients with knee osteoarthritis?
Data Source: Medline, the Cochrane Library, and EMBASE were searched for relevant articles published up to December 2002. The search engine Google was also used to search for relevant trials.
Index Terms: Index terms used included "osteoarthritis", "knee", "corticosteroid" and "glucocorticoids", and "intra-articular OR intraarticular".
Study Selection: Randomized trials and systematic reviews were considered if they specifically evaluated intra-articular steroid injection for knee osteoarthritis. Included studies focused on long-acting, potent forms of depo-corticosteroid (triamcinolone hexacetonide, methylprednisolone, betamethasone, and cortivazol). Studies needed to include a placebo arm to be considered for inclusion. A total of 5 RCTs, with data sampled from 312 patients, were selected for final inclusion.
Data Extraction: Methods not reported. Means and standard deviations and 95% confidence intervals were extracted when available.
Data Synthesis: RevMan software was used to perform the meta-analysis using both dichotomous and continuous outcomes.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.