Corticosteroid injections for osteoarthritis of the knee: meta-analysis.
OBJECTIVE
To determine the efficacy of intra-articular corticosteroid injections for osteoarthritis of the knee and to identify numbers needed to treat.


METHODS
Cochrane controlled trials register, Medline (1966 to 2003), Embase (1980 to 2003), hand searches, and contact with authors.


METHODS
Randomised controlled trial in which the efficacy of intra-articular corticosteroid injections for osteoarthritis of the knee could be ascertained.


RESULTS
In high quality studies, the pooled relative risk for improvement in symptoms of osteoarthritis of the knee at 16-24 weeks after intra-articular corticosteroid injections was 2.09 (95% confidence interval 1.2 to 3.7) and the number needed to treat was 4.4. The pooled relative risk for improvement up to two weeks after injections was 1.66 (1.37 to 2.0). The numbers needed to treat to get one improvement in the statistically significant studies was 1.3 to 3.5 patients.


CONCLUSIONS
Evidence supports short term (up to two weeks) improvement in symptoms of osteoarthritis of the knee after intra-articular corticosteroid injection. Significant improvement was also shown in the only methodologically sound studies addressing longer term response (16-24 weeks). A dose equivalent to 50 mg of prednisone may be needed to show benefit at 16-24 weeks.
Arroll
Bruce
B
Department of General Practice and Primary Health Care, School of Population Health University of Auckland, Private Bag 92019 Auckland. b.arroll@auckland.ac.nz
Goodyear-Smith
Felicity
F
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D018849:Controlled Clinical Trials as Topic; D006801:Humans; D007267:Injections; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D012307:Risk Factors
D000305:Adrenal Cortex Hormones