Intra-articular steroid injections for painful knees. Systematic review with meta-analysis.

OBJECTIVE Do intra-articular steroid injections relieve the pain of osteoarthritis (OA) of the knee? DATA SOURCES MEDLINE, Cochrane, and Internet databases were searched for randomized controlled trials. STUDY SELECTION Five randomized controlled trials involving 312 patients were found. SYNTHESIS One week after injection, treated patients were less likely to have continuing pain and had significantly lower scores on a visual analogue scale (VAS) for pain. Three to 4 weeks after injection, treated patients still had significantly less pain, but their VAS scores were no longer significantly lower than scores in the control group. Six to 8 weeks after injection, neither pain reduction nor VAS scores were significantly different between groups. CONCLUSION Intra-articular corticosteroid injection results in clinically and statistically significant reduction in osteoarthritic knee pain 1 week after injection. The beneficial effect could last for 3 to 4 weeks, but is unlikely to continue beyond that.