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Long-Term Steroid Injections May Hurt – Not Help – Knee Osteoarthritis Patients


Maggie Morio, 70, is not the type of person to let anything – much less her knee osteoarthritis  - slow her down.

“I take great pride in being independent and self-sufficient,” she said. “But sometimes my knee pain is so severe and so demoralizing that it’s hard to walk.”

Researching Knee OA

The most common form of arthritis, osteoarthritis (OA) affects more than 30 million adults in the United States, according to the Centers for Disease Control and Prevention.  A degenerative, age-related condition of the joints, OA can cause substantial pain, swelling and stiffness, primarily in older adults. But despite its prevalence, there is no current treatment to reverse OA or any effective therapy to slow or stop the disease’s progression. It is for this reason that Timothy McAlindon, MD, Chief of Rheumatology at Tufts Medical Center, has dedicated his research to identifying new therapies for knee OA.

Dr. McAlindon’s most recent research study, published in the May 16, 2017 issue of the Journal of the American Medical Association, examined whether periodic, long-term corticosteroid injections would have an effect on pain and cartilage loss in knee OA patients. One-hundred-forty knee OA patients were randomized to receive either corticosteroid or saline (placebo) injections every three months for two years (a total of eight injections). Pain was measured every three months and the subjects received MRIs at 12 and 24 month intervals to measure cartilage loss. The results were surprising.

“We found that the people who received the steroid injections did not have any long-term improvement in pain compared to the control group,” said Dr. McAlindon. “In addition, the patients who received the steroid injections suffered slightly more cartilage loss than those who had placebo. The study’s results indicate that repeated, long-term steroid injections are not an effective or efficient therapeutic strategy in the long term for knee OA patients.”

Injection Alternatives

Since she first developed knee OA 12 years ago, Morio has required five meniscus repairs to her right knee and one to her left. To reduce her knee pain, she follows her doctor’s recommendations, which include swimming, aquatherapy, physical therapy and anti-inflammatory drugs - all viable, long term alternatives to steroid injections, without any potential negative side effects. Morio also adheres to a strict diet low in gluten, salt and sugar.

“Staying sedentary is not an option for me,” said Morio. “I’m going to keep my knee joints moving and would only resort to injections or knee replacements if I had no other alternatives.”

This study was supported by the National Institutes of Health, specifically the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award R01-AR057802).

The above content is provided for educational purposes by Tufts Medical Center. It is free for educational use. For information about your own health, contact your physician.