Researchers from the Chicago Medical School of Rosalind Franklin University and the University of California, San Francisco, have found that steroid knee injections for osteoarthritis could exacerbate the disease.

The researchers evaluated X-rays and MRI scans and found that the knee injections worsened disease progression. Osteoarthritis is the most common arthritis affecting people over 32 in the U.S. About 10% of people with this condition get hyaluronic acid or steroid injections to lessen the pain.

How researchers conducted the study

 The study by the University of California included 210 participants. About 70 of them used intraarticular injections. Among this group, 26 got hyaluronic acid injections, while 44 got steroid injections. The rest of the participants hadn’t used any injection in two years.

Before they started the injections, the patients had gotten MRI scans. They got other scans at the end of the two years. The researchers monitored the severity of the osteoarthritis by examining the ligaments, joint effusion, cartilage, meniscal and above marrow lesions.

According to Dr. Upasana Upadhyay Bharadwaj, the study is the first to use whole organ assessment of the knee (WORM) with MRI to compare the effect of hyaluronic acid and corticosteroids on osteoarthritis patients.

Hyaluronic acid decreases disease progression

The findings indicated that steroid injections significantly impacted the progression of osteoarthritis. The spread was seen particularly at the medial cartilage, lateral cartilage, and lateral meniscus of the knee joint. However, the team found that hyaluronic acid decreased the progression and formation of lesions.

The Chicago Medical School conducted its research on 150 patients. The first 50 received steroid injections, the next 50 received hyaluronic acid, and the last 50 did not get any injections. Like in the first study, patients on steroid injections had worse disease progression, especially at the medial joint space.

For both studies, the initial MRIs showed similar disease progression. However, by the end of the study, the spread was more significant for those on steroid injections. The researchers state that while hyaluronic acid and steroid injections can reduce the symptoms of osteoarthritis, doctors should use steroids with caution. Instead, hyaluronic acid should be the preferred intervention for knee joint pain.