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Mechanism of action

  • Anti-inflammatory properties assumed to provide analgesic effect and decelerate joint damage
  • May reduce cytokine and metalloprotease expression
  • Experimental models show that they reduce the size, severity, and progression of both cartilage lesions and osteophyte formation

Additional Information

  • Research on corticosteroid injections in knee OA dates back to the 1950's.
  • Delivers high doses of synthetic corticosteroids to the joint, while minimising systemic side effects, with or without ultrasound guidance.
  • Available in both crystalline and non-crystalline forms, numerous formulations of corticosteroid products have been studied: betamethasone, prednisolone acetate, triamcinolone hexacetonide, methylprednisolone, hydrocortisone solution, triamcinolone acetonide, cortivazol, and methylprednisolone acetate.
  • Typically referred to as a second- or third-line OA treatment.


  1. Bannuru RR, Natov NS, Obadan IE, Price LL, Schmid CH, McAlindon TE. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis. Arthritis & Rheumatism. 2009; 61(12): 1704-1711.
  2. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database of Systematic Reviews. 2006.
  3. Creamer P. Intra-articular corticosteroid injections in osteoarthritis: do they work and if so, how? Ann Rheum Dis. 1997; 56: 634-636.
  4. Gaffney K, Ledingham J, Perry JD. Intra-articular triamcinolone hexacetonide in knee osteoarthritis: factors influencing the clinical response. Ann Rheum Dis. 1995; 54(5): 379-381.
  5. Juni P, Hari R, Rutjes AW, Fischer R, Silletta MG, Reichenbach S, da Costa BR. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database of Systematic Reviews. 2015;10.
  6. National Collaborating Centre for Chronic Conditions. Osteoarthritis: National Clinical Guideline for Care and Management in Adults. 2008.
  7. National Institute for Health and Care Excellence (NICE). Osteoarthritis: care and management. 2014.
  8. The Non-surgical Management of Hip & Knee Osteoarthritis Working Group. VA/DoD Clinical Practice Guideline for the Non-surgical Management of Hip & Knee Osteoarthritis. 2014.