Intra-articular Corticosteroid Injection in Osteoarthritis of the Knee and Hip: Factors Predicting Pain Relief—A Systematic Review

Relationship of Radiographic Osteoarthritis Severity with Treatment Outcomes after Imaging-Guided Knee Injections: A Prospective Outcomes Study

“…Therefore, referring clinicians can have more confidence that their patients graded with OARSI 2 (moderate joint space narrowing of 34 -66 %) can expect better clinical outcomes, especially at one day after the infiltration compared to the other OARSI grades. Two systematic reviews were performed in 2013 to try and identify predictors for good treatment response after intra-articular knee injections [28,29]. Maricar et al came to the conclusion that the presence of effusion, aspiration of fluid from the knee, severity of disease, absence of synovitis, injection delivery under ultrasound guidance and greater symptoms at baseline may all increase the likelihood of a positive response to intra-articular corticosteroid injections [29].…”

“…Maricar et al came to the conclusion that the presence of effusion, aspiration of fluid from the knee, severity of disease, absence of synovitis, injection delivery under ultrasound guidance and greater symptoms at baseline may all increase the likelihood of a positive response to intra-articular corticosteroid injections [29]. Hirsch et al, on the other hand, concluded that there is very limited evidence for predictive factors of pain relief following intra-articular corticosteroid injections in OA of the knee and hip, because the different studies had incongruent results [28]. An interesting fact that might have been related to better outcomes after injection treatments for the knee was a lower radiological degree of degeneration compared to patients with more progressed OA [5,29,30].…”

Pharmacologic and Non-Pharmacologic Treatment of Osteoarthritis

“…Synovitis has been shown to be associated with pain [70•]. However, synovitis was not shown to be a predictor of pain reduction in knee and hip OA after intraarticular injection of glucocorticoids [71].…”

Managing the Pain of Knee Osteoarthritis

“…Recent systematic reviews failed to identify consistent predictors of a positive clinical response to steroid injections, including radiographic grade, clinical or sonographic evidence of inflammation, or synovial hypertrophy. 37,38 Intra-articular steroids have a rapid onset of action and relatively short-term effectiveness (3-4 weeks). This short-term symptomatic relief appears to be the only evidence-based benefit of a corticosteroid injection into an osteoarthritic knee.…”