Intra-articular corticosteroids are effective in osteoarthritis but there are no clinical predictors of response.
OBJECTIVE
To show whether intra-articular steroid injections are effective in osteoarthritis; to determine factors that predict response; and to determine whether injection has a beneficial effect on muscle strength.


METHODS
Double blind, placebo controlled, crossover study in 59 patients with symptomatic osteoarthritis of the knee. Outcome measure-Primary outcome measure: change in visual analogue score for pain at three weeks. Predictors of response analysed using logistic regression with a 15% decrease in pain score at three weeks defining response.


RESULTS
Intra-articular methyl prednisolone acetate produced a significant reduction in visual analogue pain score at three weeks compared to both baseline (median change -2.0 mm, interquartile range -16.25 to 4.0) and placebo (median 0.0 mm, interquartile range -9.0 to 6.25). No clinical predictors of response could be identified. Muscle strength was not significantly improved in the short term by intra-articular injection.


CONCLUSIONS
Intra-articular corticosteroids are effective for short term relief of pain in osteoarthritis but predicting responders is not possible. There may be a place for their more widespread use.
Jones
A
A
Rheumatology Unit, City Hospital, Hucknall Road, Nottingham, United Kingdom.
Doherty
M
M
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000503:physiopathology; D010003:Osteoarthritis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D010147:Pain Measurement; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011239:Prednisolone