Hip, knee steroid injections may be harmful

Henrietta Strickland
October 17, 2019

Nearly nine million Britons have osteoarthritis, caused as the cartilage that protects joints wears away.

Scientific doctors inject anti-inflammatory corticosteroids straight into the hip and knee joints to handle osteoarthritic anxiety.

USA researchers looked at 459 adults given injections past year for hip and knee osteoarthritis. Ten per cent had complications in their hips and 4 per cent in their 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 corresponding author Ali Guermazi, MD, PhD, chief of radiology at VA Boston Healthcare System and professor of radiology at BUSM. "But now we suspect this is not necessarily the case".

OA, or "wear and tear arthritis", occurs when the cartilage in the joints breaks down, which commonly affects the elderly. In the USA, more than 30 million people have the disease, according to the Centers for Disease Control and Prevention.

The researchers recommend careful scrutiny of patients with mild or no osteoarthritis on X-rays who are referred for injections to treat joint pain, especially when the pain is disproportionate to the imaging findings. Studies into their safety, however, suggest they may trigger everything from joint swelling to back pain and infections. The patients came back two-to-15 months later for a check-up. A frequently (thousands per day worldwide) performed treatment for osteoarthritis and other joint related pain syndromes are intra-articular corticosteroid injections, yet there is conflicting evidence on their potential benefit. Some patients may experience "accelerated arthritis and joint destruction" as a result of these injections.

On the back of their results, the scientists are calling for scans to be carried out on patients before corticosteroid injections to ensure they have no existing fractures that may be made worse.

But the study by Boston University School of Medicine found that the treatment could speed up a joint's disintegration and force patients to have total knee or hip replacements.

Dr Guermazi warned sport stars of the doubtless dangers in the employ of the injections, asserting: 'Intra-articular joint injection of steroids is a extraordinarily frequent therapy for osteoarthritis-connected anxiety, nonetheless doubtless aggravation of pre-existing prerequisites or staunch aspect effects in a subset of sufferers have to serene be explored extra to better realize the dangers associated with it.

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