If the knee hurts, doctors often inject cortisone-like glucocorticoids into the joint. This is supposed to fight the inflammation and at least relieve pain in the short term. A US study on 140 osteoarthritis patients now shows that regular injections into the knee could even damage the articular cartilage and accelerate wear and tear. test.de presents the study and says what alternatives there are for osteoarthritis patients.
Injections are supposed to reduce inflammation
Joint wear is particularly common in the knee. In technical jargon, doctors speak of gonarthrosis. It arises from the fact that the articular cartilage loses its elasticity, becomes thinner and rougher. If the osteoarthritis progresses, fine particles rub off – inflammation can develop. Anti-inflammatory agents such as the cortisone-like glucocorticoids are said to provide relief to those affected. They are injected directly into the joint. However, the effectiveness of such syringes is controversial. A study by scientists at Tufts Medical Center in Boston, USA, has now produced surprising results: Osteoarthritis patients do not benefit from such syringes in the long term – on the contrary.
Study Tufts Medical Center: Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis
Every three months, table salt or triamcinolone
Doctors included 140 patients in their study. Every patient had painful knee osteoarthritis and an inflammatory effusion in the joint. The doctors divided the patients into two groups: the first group received an injection of saline into the knee joint every three months, the second group received 40 milligrams of the glucocorticoid triamcinolone. The applications each ran for two years. Using magnetic resonance tomography at the beginning and after one and two years, the doctors recorded changes in the volume of the knee joint. How severe the pain was was recorded every three months – using a “pain scale”. In order to get a realistic result, the study participants stopped their pain medication shortly beforehand to know dermal fillers cost.
Conclusion: joint degradation accelerated
The result was unexpected: injections with glucocorticoids brought no benefits. On the contrary: the loss of cartilage mass was even more pronounced in the triamcinolone patients after two years than in those who had received saline injections. The triamcinolone injections did not stop the breakdown of the joints, but accelerated it. In addition, the pain sensation did not decrease noticeably in either of the two groups. Those affected are unlikely to have felt any real improvement in everyday life. Sober conclusion of the study: repeated injections with glucocorticoids can damage the knee joint. They are not recommended as long-term therapy.
Syringes with hyaluronic acid are also not very suitable
In addition to glucocorticoids, doctors usually inject hyaluronic acid directly into the joint for gonarthrosis. Hyaluronic acid is a natural component in the body; it is supposed to improve the properties of the synovial fluid and to form a protective layer on the surface of the articular cartilage. The medical experts from Stiftung Warentest classify hyaluronic acid as unsuitable for these purposes ( drugs tested: osteoarthritis and joint problems ). Studies on the effectiveness suggest that hyaluronic acid can reduce pain only for a short time and only slightly. There are also some undesirable effects such as hypersensitivity reactions to the skin. Our medication test database shows which medications are suitable for osteoarthritis.
Artificial knee: weigh your decision carefully
The greater loss of cartilage substance as a result of regular injections could mean that ultimately more patients will need an artificial knee joint. According to the Federal Statistical Office, around 187,000 patients received an artificial knee in Germany in 2016. An evaluation of international studies shows that in general every fifth patient is not satisfied with the prosthesis. “An implant can never completely replace the natural bone,” says the German Society for Endoprosthetics. Patients should weigh individual risks and expectations prior to the procedure. Sometimes a partial prosthesis is sufficient ( knee joint: partial joint replacement involves fewer risks ).
What those affected can do
So what can those affected do? It is best to work out an individual therapy mix with specialists in order to maintain your joint function and thus mobility. There are numerous options available. Most importantly, keep moving and strengthen the muscles around the affected joint. Suitable, gentle sports for osteoarthritis include cycling, swimming, aqua aerobics, hiking or jogging on soft floors. It helps obese patients if they lose weight and in this way relieve their joints.
Tip: Our osteoarthritis guide gives numerous recommendations on how to stay mobile and which treatment methods are available.
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