Steroid injections effective for knee osteoarthritis
The Journal of Family Practice. 2004 August;53(8):604-612
August 1, 2004|The Journal of Family Practice
Author and Disclosure Information
- CLINICAL QUESTION: Are intra-articular corticosteroids effective for symptoms of osteoarthritis of the knee?
- STUDY DESIGN: Meta-analysis (randomized controlled trials)
- SETTING: Various (meta-analysis)
- SYNOPSIS: The authors of this meta-analysis identified 10 studies of randomized placebo-controlled trials of intra-articular corticosteroids for osteoarthritis of the knee by searching 3 databases, contacting authors, and checking references of identified articles. In the 6 small studies (n=317) that measured symptom improvement, overall improvement was seen following the injection (number needed to treat [NNT]=1.3–3.5). The actual response (not response rate), however, could be small—any improvement was taken to be clinically relevant. An evaluation of the only 2 high-quality studies showed more improvement after 4 to 6 months with steroid injection than with placebo (NNT=4.4; 95% confidence interval, 1.8–23.8). Doses were equivalent to 6.25 mg to 80 mg of prednisone. The authors did not look at long-term effects.
BOTTOM LINE
Intra-articular steroids produced some measure of improvement greater than placebo, with approximately 2 to 4 patients requiring treatment for an additional 1 patient to benefit. This meta-analysis, however, included relatively few patients, and the magnitude of the benefit was not quantified in this study. (LOE=1a)
