Steroid injections effective for knee osteoarthritis

Q&A

J Fam Pract. 2004 August;53(8):604-612

CLINICAL QUESTION: Are intra-articular corticosteroids effective for symptoms of osteoarthritis of the knee?
STUDY DESIGN: Meta-analysis (randomized controlled trials)
SETTING: Various (meta-analysis)
SYNOPSIS: The authors of this meta-analysis identified 10 studies of randomized placebo-controlled trials of intra-articular corticosteroids for osteoarthritis of the knee by searching 3 databases, contacting authors, and checking references of identified articles. In the 6 small studies (n=317) that measured symptom improvement, overall improvement was seen following the injection (number needed to treat [NNT]=1.3–3.5). The actual response (not response rate), however, could be small—any improvement was taken to be clinically relevant. An evaluation of the only 2 high-quality studies showed more improvement after 4 to 6 months with steroid injection than with placebo (NNT=4.4; 95% confidence interval, 1.8–23.8). Doses were equivalent to 6.25 mg to 80 mg of prednisone. The authors did not look at long-term effects.

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