Hip and knee steroid injections could accelerate arthritis

Commonly given hip and knee steroid intra-articular injections may be harmful

Woman-with-hip-joint-pain-Sport-exercising-injury-shut Woman with hip joint pain | Shutterstock

A newly published study has warned common hip and knee steroid intra-articular injections given to reduce pain and inflammation from arthritis may be harmful in some patients with at-risk conditions or may cause complications not well understood.

Researchers from Boston University School of Medicine (BUSM) in the US  found that accelerated arthritis and joint destruction can be the unintended result of intra-articular corticosteroid injections.

Osteoarthritis of the hip and knee is among the most common joint disorders. It causes wear-and-tear of the cartilage cushioning the joints. This will result in bones rubbing against each other, causing severe disability. 

A frequently performed treatment for osteoarthritis and other joint related pain syndromes are intra-articular corticosteroid injections, yet there is conflicting evidence on their potential benefit.

The research on patients injected last year in the hips and knees found out that eight per cent had complications, with 10 per cent in the hips and four per cent in the knees.

"We are now seeing these injections can be very harmful to the joints with serious complications such as osteonecrosis, subchondral insufficiency fracture and rapid progressive osteoarthritis," said Ali Guermazi, a professor of radiology at BUSM.

"Intra-articular corticosteroid injection should be seriously discussed for pros and cons. Critical considerations about the complications should be part of the patient consent which is currently not the case right now," he added.

Researchers noted that intra-articular corticosteroid injections are increasingly performed for treatment of pain in hip and knee osteoarthritis.

They suggest that the radiologic community should actively engage in high-quality research about this topic, to better understand potential at-risk conditions prior to intervention.

The community should also better understand potential adverse joint events following these procedures to avoid possible complications. 

The study of patients, who had received these injections in 2018, was published online in the journal Radiology. 

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