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Study: No added benefit from corticosteroid injection prior to exercise shown in patients with OA
No improvements in pain were seen after adding an intra-articular injection of 40 mg of corticosteroids prior to the initiation of an exercise regimen in patients with osteoarthritis knee pain, according to recently published study findings.
Researchers studied 45 patients with osteoarthritis (OA) from the Copenhagen University Hospital who received intervention and 44 patients who received placebo and completed the trial. Patients were 40 years of age or older and had radiographic confirmation of tibiofemoral OA, knee pain while walking and a BMI of 35 or less. Patients were excluded in the presence of prior corticosteroid injection or exercise therapy participation within the prior 3 months; history of knee arthroplasty; inflammatory arthritis; inability to exercise; contraindications to corticosteroid injection; and pain syndromes, such as fibromyalgia or spinal nerve root compression syndromes.
Patients received a 1-mL injection into the knee with 40 mg methylprednisone acetate dissolved into 4 mL of lidocaine hydrochloride or placebo comprising 1 mL of isotonic saline combined with 4 mL of lidocaine hydrochloride injected into the most symptomatic knee. Two weeks later, the participants engaged in a supervised, 12-week exercise program. All participants attended the same exercise classes. Assignment to treatment or placebo was randomized, and participants, staff and those who assessed outcomes were blinded to treatment or placebo status.
Outcomes related to KOOS were measured at week 2 at the beginning of exercise, week 14 after exercise cessation and at follow-up week 26. Although improvements were seen in both groups, no statistically significant group differences were seen at week 2 through week 26, aside from a slight enhancement of hamstring muscle strength in the corticosteroid group. However, the results of MRI imaging showed slightly better outcomes with the placebo group, according to the researchers. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.