Tuesday, June 18, 2024

Impact of Intra-Articular Corticosteroid Injections on Osteoarthritis: A Systematic Review

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The effectiveness of intra-articular corticosteroid (CS) injections in treating osteoarthritis (OA) remains a complex topic. By synthesizing results from various animal studies, this systematic review seeks to clarify the benefits and drawbacks of CS treatments. The review evaluates key factors such as cartilage condition, synovial health, pain levels, and clinical outcomes to present a comprehensive picture of CS’s role in OA management.

A comprehensive systematic review was conducted on preclinical evidence regarding intra-articular corticosteroid (CS) injections for osteoarthritis (OA) joints. The study included a diverse range of animal models, aiming to elucidate the effects of CS on joint health and function.

Methodological Approach

The review encompassed a detailed analysis of 32 articles, which collectively examined 1079 joints in both small and large animals. Researchers utilized databases such as PubMed, Cochrane, and Web of Science to gather relevant studies. Key evaluations included morphological, histological, and immunohistochemical assessments, alongside clinical outcomes, biomarkers, and imaging results. The risk of bias was quantified using the Systematic Review Centre for Laboratory Animal Experimentation’s tool.

Key Findings

The results indicated that 68% of the studies reported positive effects from CS injections, while 16% observed detrimental outcomes. Notably, 68% and 60% of the studies showed improvements in cartilage and synovial health, respectively. However, adverse effects were noted in 11% and 20% of the studies for these parameters. Clinical indicators like pain, lameness, and joint swelling improved in 63% of the studies but worsened in 13%.

Evidence regarding imaging and biomarkers was limited, and there was no consensus on the optimal CS type, dose, formulation, or injection protocol. The bias assessment revealed a 28% low and an 18% high risk of bias, indicating variability in study quality.

Inferences for Practical Application

• CS injections can improve cartilage and synovial health in the majority of cases.
• Clinical symptoms such as pain and swelling are likely to improve but may worsen in some instances.
• The choice of CS type and injection protocol remains critical for maximizing benefits.
• Further research is needed to minimize potential adverse effects.

In conclusion, intra-articular CS injections offer a range of outcomes in treating OA joints in animal models. While short-term benefits include pain relief and improved joint function, there is also the potential for negative effects. This highlights the necessity for further research to define specific indications and treatment protocols to harness the anti-inflammatory benefits while mitigating risks.

Original Article: Knee Surg Sports Traumatol Arthrosc. 2024 May 30. doi: 10.1002/ksa.12242. Online ahead of print.

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