Local Treatment of a Painful Knee with Cortiscosteroids: The Efficacy of Intra-articular Injection Compared with Peri-articular Soft Tissue Infiltration

Abstract

Objectives

Corticosteroid injections are widely used to palliate the symptoms of knee osteoarthritis. However, no research involving the means of administration has been executed to date. We tested the hypothesis that peri-articular soft tissue infiltration is superior to intra-articular injection as it addresses the target tissue.

Methods

Sixty-three patients with osteoarthritis grade 1–3/4 were randomized to receive intra-articular or peri-articular injection of methylprednisolone acetate [80 mg] and they were followed for three months. The patients were assessed with pain categories adopted from Western Ontario and McMaster Universities (WOMAC) osteoarthritis index.

Results

Both the intra-articular and the peri-articular groups demonstrated improvement in baseline WOMAC osteoarthritis index scores [a median decrease from 56.6 to 24.0 points and from 62.5 to 21.7 points respectively; P  <  0.001 for both].

Conclusion

Peri-articular infiltration of corticosteroids is an alternative method of local administration in knee grade 1–3/4 osteoarthritis.

Keywords:

• Corticosteriods
• osteoarthritis
• knee
• pain