The cortisone injections have gotten a bad rap in recent years as a treatment for arthritis pain, because steroids are known to damage cartilage and could potentially cause further joint deterioration.
However, new research suggests that, when used wisely, cortisone injections are as safe as other types of administration used to treat knee arthritis.
The results of the study have been published in the scientific journal Arthritis and Rheumatology.
Cortisone Injections: What’s the Truth?
Cortisone injections, as long as they are occasional, do not appear to cause the knees to deteriorate faster than hyaluronic acid injections. a substance injected to lubricate stiffened joints from arthritis, the researchers said: “Knee replacement rates were, if anything, somewhat lower in the group that received the cortisone injections“Said senior researcher Dr. David Felson, professor of medicine and epidemiology at the Boston University School of Medicine.
Felson added however that the study only looked at people who had received knee cortisone injections on and off and should not be construed as giving the green light to regular injections for years to come: “What we know from the study that we can trust is that some cortisone injections will not really cause many problems “, Felson said: “Repeated injections every three months for years are not conceivable to cause any problems.”
Steroids are recognized as toxic to cartilage, the connective tissue that prevents bones from rubbing against each otherexplained Dr. Melissa Leber, Director of the Sports Medicine Division of the Emergency Department at the Icahn School of Medicine at Mount Sinai in New York City: “If given often, they will damage the cartilageNoted Leber, who played no role in the study.
A 2019 study reported a three times greater risk of progression of knee arthritis in people who had received repeated cortisone injections, compared to people who had never received the injection, Felson and his colleagues said. However, no clinical studies have ever compared the two most common types of knee arthritis injections: cortisone injections and hyaluronic acid injections.
The two types of administration act differently in the joint and are sometimes used in combination, Leber said. Cortisone injections are anti-inflammatory and help reduce pain, while hyaluronic acid injections are like a gel that provides lubrication in the diseased joint.: “When WD40 is injected into the knee, it works to allow for smoother gliding into the joint“Explained Leber.
Unlike cortisone, hyaluronic acid is not harmful to cartilage. The latest study looked at nearly 800 people with knee arthritis, of whom 4 out of 5 reported receiving cortisone injections for knee pain. The rest reported receiving hyaluronic acid injections.
After seven years of follow-up, the researchers found that those who received steroid injections did not experience greater cartilage loss than those treated with hyaluronic acid. In fact, people who received cortisone injections were about 25 percent less likely to need a total knee replacement than those who received hyaluronic acid.
The message to knee arthritis patients about cortisone administration is simple: “Don’t be afraid, nothing bad will happen with one dose or even a few doses“, Felson specified. “People should be reassured. They shouldn’t avoid getting effective treatment. “
The results reinforce the approach that orthopedic specialists already adopt in distributing cortisone to treat knee arthritis: “If someone already has several cartilage damage in the knee, a lot of arthritis, then we don’t worry so much about using a steroid to help control pain “ Leber noted. “Damaging them a little more just to give them good pain control is a trivial matter. It’s not that risky “.
“In someone who is young, between 20 and 40 years old, who has very little damage to the cartilage but has pain, we try to use it sparingly “, has continued. “Would you use them occasionally in a young person? Yes. It is only a one-time thing. The steroid is harmful to cartilage, but that doesn’t mean it’s harmful to every patient “Leber concluded. “It is a situation that must be assessed on a case-by-case basis. “
“Regardless, no patient receives frequent cortisone injections, whatever their condition“Added the doctor Jeffrey Schildhorn, an orthopedic surgeon of the Lenox Hill Hospital in New York City: “ If you give someone a chance in January and they come back in April saying they want another one, and they come back in August and they want another one, how well are they working out? ” said Schildhorn, who was not part of the study: “They don’t work if you only have two or three months of relief“, Concluded the expert.
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