Progression of Knee Osteoarthritis With Use of Intraarticular Glucocorticoids Versus Hyaluronic Acid

Justin Bucci; Xiaoyang Chen; Michael LaValley; Michael Nevitt; James Torner; Cora E Lewis; David T Felson

doi:10.1002/art.42031

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Journal article

Progression of Knee Osteoarthritis With Use of Intraarticular Glucocorticoids Versus Hyaluronic Acid

Justin Bucci, Xiaoyang Chen, Michael LaValley, Michael Nevitt, James Torner, Cora E Lewis and David T Felson

Arthritis & rheumatology (Hoboken, N.J.), Vol.74(2), pp.223-226

02/2022

DOI: 10.1002/art.42031

PMCID: PMC8795477

PMID: 34807518

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Abstract

To determine whether intraarticular glucocorticoid (GC) injections are associated with increased knee osteoarthritis (OA) progression compared to hyaluronic acid (HA) injections, which have been reported to delay OA progression and knee replacement. We identified participants from 2 large cohort studies, the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study. Study visits were performed at regular intervals and included questionnaires about intraarticular GC or HA injection use in the previous 6 months and incident total knee replacement (TKR). Knee radiographs were obtained at each study visit and interpreted in a similar manner. Outcome measures were radiographic progression based on Kellgren/Lawrence (K/L) grade and joint space narrowing (JSN) for both cohorts and based on medial joint space width for OAI participants, and incident TKR. We compared preinjection and postinjection radiographs to generate rate ratios of progression comparing GC injection with HA injection. A Cox proportional hazards model was used to estimate the rate of TKR for both groups. We studied 791 participants (980 knees) with knee OA, of whom 629 reported GC injection use and 162 HA injection use. Rate ratios of progression were similar between those receiving GCs and those receiving HA for JSN (1.00 [95% confidence interval (95% CI) 0.83-1.21]), K/L grade (1.03 [95% CI 0.83-1.29]), and medial joint space width (1.03 [95% CI 0.72-1.48]). Hazard of TKR was slightly lower for those receiving intraarticular GC compared to those receiving HA (hazard ratio 0.75 [95% CI 0.51-1.09]). Intraarticular GC injections are not associated with an increased risk of knee OA progression compared to HA.

Details

Title: Subtitle: Progression of Knee Osteoarthritis With Use of Intraarticular Glucocorticoids Versus Hyaluronic Acid
Creators: Justin Bucci - Boston University, Boston, Massachusetts
Xiaoyang Chen - Boston University, Boston, Massachusetts
Michael LaValley - Boston University, Boston, Massachusetts
Michael Nevitt - University of California at San Francisco
James Torner - University of Iowa, Iowa City
Cora E Lewis - University of Alabama at Birmingham
David T Felson - University of Manchester and the NIHR Manchester Musculoskeletal Biomedical Research Centre, and Manchester University Hospitals NHS Foundation Trust, Manchester, UK
Resource Type: Journal article
Publication Details: Arthritis & rheumatology (Hoboken, N.J.), Vol.74(2), pp.223-226
DOI: 10.1002/art.42031
PMID: 34807518
PMCID: PMC8795477
NLM abbreviation: Arthritis Rheumatol
ISSN: 2326-5191
eISSN: 2326-5205
Grant note: U01 AG018947 / NIA NIH HHS U01 AG018832 / NIA NIH HHS U01 AG19069 / NIH HHS P30 AR072571 / NIAMS NIH HHS U01 AG019069 / NIA NIH HHS U01 AG18820 / NIH HHS NIHR Manchester Biomedical Research Centre U01 AG18832 / NIH HHS U01 AG18947 / NIH HHS P30 AR072571 / NIH HHS U01 AG018820 / NIA NIH HHS
Language: English
Date published: 02/2022
Academic Unit: Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9984214700502771

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