Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis: A Randomized Clinical Trial

Review written by Dr Anthony Teoli info

Key Points

  1. In individuals with knee osteoarthritis, quarterly injections of 40mg of triamcinolone over 2 years resulted in significantly greater cartilage volume loss compared to saline injections.
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BACKGROUND & OBJECTIVE

Inflammation is common in osteoarthritic knee joints and is associated with progression of cartilage damage (1). As a result, supressing these inflammatory processes with corticosteroids could potentially slow the progression of knee osteoarthritis. However, there is evidence to suggest that there is a time- and dose-dependent effect of intra-articular corticosteroid injections on articular cartilage, with beneficial effects occurring at low doses and durations and detrimental effects occurring at high doses and durations (2). Therefore, the objective of this study was to determine the effects of an intra-articular corticosteroid injection every 3 months on progression of cartilage loss and knee pain.

Inflammation is associated with progression of cartilage damage in knee joints.
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Current evidence does not support the use of intra-articular corticosteroid injections as a treatment for patients with symptomatic knee osteoarthritis.

METHODS

This two-year randomized, placebo-controlled, double-blinded trial included 140 patients ≥45 years old with symptomatic knee osteoarthritis and ultrasound-confirmed synovitis. Participants were randomized to receive either a 40mg intra-articular triamcinolone injection (corticosteroid, n=70) or a saline injection (placebo, n=70) every 12

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