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Honored Contributor
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Registered: ‎05-23-2010

Knee arthritis advances more quickly in those that receive cortisone injections

[ Edited ]

Two new studies will be presented at the Radiological Society of North America's annual meeting. The key finding of the studies is that knee osteoarthritis advanced faster in patients that received cortisone shots in the knees than those who did not get these shots. Injections  of hyaluronic acid were compared with a control group of patients not receiving these shots  and the hylauronic acid was associated with slower progression of arthritis. Both studies assessed patients from a years long observational research project involving almost 5000 people with knee osteoarthritis. Note that only a small portion of the 5000 were involved in these two new studies. .

 

In one of the two new studies , X-rays from 50 patients that received the cortisone shots, X-rays from people that received the hyaluronic acid were compared with X- rays from a control group of 50 patents that receive no shots. The X-rays were collected for four years. The X-rays revealed worse arthritis progression among those that received the cortsone injections than the other two groups, the hyaluronic acid and the no injections control groups. This part of the study took place at Chicago Medical School. This study was co-authored by Azad Darbandi

 

In the second study, MRIs from 210 participants were examined. There were 44 that had received the cortisone injections and 26 that had received the hyaluronic acid injections.

Researchers looked at MRIs taken when the injections occurred and also looked at MRIs from two years prior to the injections and from two years after. There was more severe cartilage deterioration at the end of the last two years among those that had the cortisone injections. This study was done at UCSF radiology and biomedical imaging department. This study was co authored by Dr. Upasana Bharadawaj.



Prior research in 2019* found that cortisone shots in the hips and knees accelerated the arthritis and hastened the need for joint replacement operations.

 

An analysis last year, 2021,  found hastening of arthritis progression among both patients that received injections of cortisone or hyaluronic acid.**

 

* Published in the journal Radiology, lead author, Dr. Ali Guermazi , Professor of Radiology at Boston University School of Medicine. Intra-articular Corticosteroid  Injections of the Hips and Knee: Perhaps Not as Safe as We Thought?

 

**Published  in Arthritis & Rheumatology/Volume 74, Issue 2/ p.223-226, Nov. 22, 2021 by Justin Bucci, Progression of Knee Osteoarthritis With Use of Intraarticular Glucocorticoids Versus Hyaluronic Acid.

Honored Contributor
Posts: 30,916
Registered: ‎05-10-2010

Re: Knee arthritis advances more quickly in those that receive cortisone injections

I think those of us who had cortisone injections for OA of the knee know that. They do tell us that when we opt for the injections and it's why doctors won't do them too frequently. I had interventional radiology injections and they would only do them every 4 months. The relief was amazing. After an injection, the pain was gone and my knee was mobile.  I'd limp into the IR department and dance my way out.  But that only lasted 10 or 12 weeks. Also the injections become less effective over time. They are great but they are not a permanent solution. I had them for 3 years until I had my left knee replaced.

Honored Contributor
Posts: 18,604
Registered: ‎10-25-2010

Re: Knee arthritis advances more quickly in those that receive cortisone injections

I found that the injections didn't work.  i have had several different types.

 

I am getting my right knee replaced in about two weeks.  My left knee looks awful on x-rays, but doesn't hurt. ( doctors are baffled )  Sometimes the doctors have injected that knee as well even though I didn't need any pain relief

 

When I read that the injections can make your knees worse, I was not happy.  I hope the unwanted injections didn't hurt my left knee. 

There is a good reason, I try to avoid doctors when possible.  

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Posts: 5,291
Registered: ‎06-15-2015

Re: Knee arthritis advances more quickly in those that receive cortisone injections

@Mindy D 

 

Good information. Both of my Ortho Doctor friends, 1 is a Micro Surgery Spinal Specialist, the other specializes in Hip and Knee Repair and Replacement, told me this years ago.

 

Both of them said that they would give 2 Cortisone Shots, Max, to anyone in the same joint. For exactly the reasons given in this study. Both of my friends are Certified in Sports Medicine. Both played in my Adult Hockey League, and both with the same last name. One is from Philadelphia the other from Saskatchewan, a Canadian Province.

 

hckynut 🇺🇸

hckynut(john)
Respected Contributor
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Registered: ‎05-30-2012

Re: Knee arthritis advances more quickly in those that receive cortisone injections

I have had Hyaluronic Acid knee injections.....the results have been very good...I go approximately every six months...I do not require any pain medication...for me it has worked well...

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Registered: ‎03-09-2010

Re: Knee arthritis advances more quickly in those that receive cortisone injections


@sann wrote:

I have had Hyaluronic Acid knee injections.....the results have been very good...I go approximately every six months...I do not require any pain medication...for me it has worked well...


I have had one with minimal results, going to go back in a few months to try for a second shot, my doc said this time he will use a different brand, worth a shot, literally!!

Respected Contributor
Posts: 2,170
Registered: ‎05-30-2012

Re: Knee arthritis advances more quickly in those that receive cortisone injections


@Shelbelle wrote:

@sann wrote:

I have had Hyaluronic Acid knee injections.....the results have been very good...I go approximately every six months...I do not require any pain medication...for me it has worked well...


I have had one with minimal results, going to go back in a few months to try for a second shot, my doc said this time he will use a different brand, worth a shot, literally!!


Here's hoping you have good results 👍

Valued Contributor
Posts: 767
Registered: ‎10-19-2022

Re: Knee arthritis advances more quickly in those that receive cortisone injections

[ Edited ]

@Mindy D 

 

 

Very interesting article.

 

I think this also could apply to the arthritic bunion in my toe that I had removed last year.  

 

For two years prior to the surgery, I'd get the injections.  Each time they wore off, the pain was much worse than before.  

 

 

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Posts: 3,661
Registered: ‎07-18-2013

Re: Knee arthritis advances more quickly in those that receive cortisone injections

I think doctors have been up front about that for a long time.  For some  patients I think getting the pain relief knowing they are heading  toward surgery any way is worth the side effects.  

If my dog doesn't like you, neither do I.
Honored Contributor
Posts: 30,916
Registered: ‎05-10-2010

Re: Knee arthritis advances more quickly in those that receive cortisone injections

@Carmie wrote:
I found that the injections didn't work. i have had several different types.
I am getting my right knee replaced in about two weeks. My left knee looks awful on x-rays, but doesn't hurt. ( doctors are baffled ) Sometimes the doctors have injected that knee as well even though I didn't need any pain relief
When I read that the injections can make your knees worse, I was not happy. I hope the unwanted injections didn't hurt my left knee. 
There is a good reason, I try to avoid doctors when possible.  

 

Unwanted injections?????   Does that mean they dragged you out of your home and held you down and injected you against your will?