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Intra-articular therapy in osteoarthritis
I Uthman1, J-P Raynauld, B Haraoui
1Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon. iuthman@aub.edu.lb
Postgraduate Medical Journal
|September 5, 2003
Summary
Intra-articular corticosteroids and hyaluronic acid injections are common osteoarthritis treatments, despite limited evidence of altering disease progression. Steroids are recommended for effusions, while hyaluronic acid suits dry knees.
Area of Science:
- Orthopedics
- Rheumatology
- Pharmacology
Background:
- Osteoarthritis (OA) is a degenerative joint disease.
- Intra-articular therapies are used to manage OA symptoms.
Purpose of the Study:
- To review intra-articular therapies for osteoarthritis from 1968-2002.
- To identify commonly used and investigated intra-articular treatments for OA.
Main Methods:
- Medline literature search from 1968-2002.
- Keywords: "intra-articular" and "osteoarthritis".
Main Results:
- Corticosteroids and hyaluronic acid are the most frequent intra-articular therapies for OA.
- Numerous other agents have been investigated with limited convincing evidence.
- These common therapies are used when other treatments fail due to efficacy or toxicity.
Conclusions:
- Corticosteroids are suggested for knees with effusion.
- Hyaluronic acid may be preferred for symptomatic "dry" knees.
- Intra-articular therapies are attractive due to perceived benefits and low side effect profiles, despite weak evidence on disease modification.