Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2004 Apr 10;328(7444):869.
doi: 10.1136/bmj.38039.573970.7C. Epub 2004 Mar 23.

Corticosteroid injections for osteoarthritis of the knee: meta-analysis

Bruce Arroll  1 , Felicity Goodyear-Smith
Affiliations
Meta-Analysis

Corticosteroid injections for osteoarthritis of the knee: meta-analysis

Bruce Arroll et al. BMJ. .

Abstract

Objectives: To determine the efficacy of intra-articular corticosteroid injections for osteoarthritis of the knee and to identify numbers needed to treat.

Data sources: Cochrane controlled trials register, Medline (1966 to 2003), Embase (1980 to 2003), hand searches, and contact with authors.

Inclusion criteria: Randomised controlled trial in which the efficacy of intra-articular corticosteroid injections for osteoarthritis of the knee could be ascertained.

Results: In high quality studies, the pooled relative risk for improvement in symptoms of osteoarthritis of the knee at 16-24 weeks after intra-articular corticosteroid injections was 2.09 (95% confidence interval 1.2 to 3.7) and the number needed to treat was 4.4. The pooled relative risk for improvement up to two weeks after injections was 1.66 (1.37 to 2.0). The numbers needed to treat to get one improvement in the statistically significant studies was 1.3 to 3.5 patients.

Conclusion: Evidence supports short term (up to two weeks) improvement in symptoms of osteoarthritis of the knee after intra-articular corticosteroid injection. Significant improvement was also shown in the only methodologically sound studies addressing longer term response (16-24 weeks). A dose equivalent to 50 mg of prednisone may be needed to show benefit at 16-24 weeks.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Summary of search results
Fig 2
Fig 2
Improvements up to two weeks after steroid injection in knee
Fig 3
Fig 3
Improvements at 16-24 weeks after high dose steroid injection in knee for two high quality studies
Fig 4
Fig 4
Visual analogue scale for pain up to two weeks after steroid injection in knee
Fig 5
Fig 5
Funnel plot for corticosteroids compared with placebo
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis 2001;60: 91-7. - PMC - PubMed
    1. Raynauld J, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee. Arth Rheum 2003;48: 370-7. - PubMed
    1. American College of Rheumatology subcommittee on osteoarthritis guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee. Arth Rheum 2000;43: 1905-15. - PubMed
    1. Ayral X. Injections in the treatment of osteoarthritis. Best Pract Res Clin Rehumatol 2001;15: 609-26. - PubMed
    1. Pendleton A, Arden N, Dougados M, Doherty M, Bannwarth B, Bijlsma JW, et al. EULAR recommendations for the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2000;59: 936-44. - PMC - PubMed

Publication types

Substances