Corticosteroid Injections In The Hip And Knee: Perhaps Not As Safe As We Thought?

Mito

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Abstract
Osteoarthritis (OA) of the hip and knee is among the most common joint disorders. Intra-articular corticosteroid (IACS) injections are frequently performed to treat OA and other joint-related pain syndromes; however, there is conflicting evidence on their potential benefit. There is a lack of prospective and large retrospective studies evaluating potential joint findings, including increased risk for accelerated OA progression or adverse joint events, after treatment with IACS injection. Four main adverse joint findings have been structurally observed in patients after IACS injections: accelerated OA progression, subchondral insufficiency fracture, complications of osteonecrosis, and rapid joint destruction, including bone loss. Physicians, including radiologists, should be familiar with imaging findings and patient characteristics that may help them identify potential joints at risk for such events. The purpose of this report is to review the existing literature, describe observed adverse joint events after IACS injections, and provide an outlook on how this may affect clinical practice. Additional research endeavors are urgently needed to better understand and identify risk factors prior to intervention and to detect adverse joint events after injection as early as possible to prevent or minimize complications.

https://pubs.rsna.org/doi/10.1148/radiol.2019190341

“Corticosteroid injections used to treat osteoarthritis pain in the hip and knee may be more dangerous than previously thought, according to a special report published in the journal Radiology. Researchers suggested that injection-associated risks like rapid progressive osteoarthritis, which eventually may lead to joint collapse, should be integrated into consent forms so that patients are aware of the potential risks associated with these treatments.”

Steroid Injections of Hip and Knee May Damage Joints
 

Blossom

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That’s not too surprising actually. I feel like some doctors already knew this from experience. My husband was warned about it when he took steroid injections in his foot years ago.
 

Nokoni

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I got such a steroid injection once for a ruptured disk. The relief was fantastic and almost immediate but, of course, temporary. That was 15 or 20 years ago and since then my back had become so unstable that much of the time I was unable to take proper care of my pets, or even to tie my shoes. A month or two ago I discovered boron (borax) and my back now feels quite solid. Haven't done any stress testing yet but I can do all normal activities without restriction or pain. I cleaned the bathroom floor yesterday and it wasn't even hard. Couple months ago I would have simply laughed at the very idea. And my knees have improved so much I can go up and down stairs without even holding on to the rail, and even carrying stuff. My daughter has a congenital back condition that gives her significant pain just from walking around Costco. Started her on boron and she's now very much improved too. After the first post-boron trip through Costco I asked her, the following day, if she had had much pain. Normally I would see her leaning against stuff or squatting down, and when it was time to move again there was real discomfort on her face straightening back up, and I hadn't noticed any that trip. She paused for a moment, then looked up at me and said, "I didn't even think about it." Boron is a straight-up miracle for joint pain.
 

teds

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I got such a steroid injection once for a ruptured disk. The relief was fantastic and almost immediate but, of course, temporary. That was 15 or 20 years ago and since then my back had become so unstable that much of the time I was unable to take proper care of my pets, or even to tie my shoes. A month or two ago I discovered boron (borax) and my back now feels quite solid. Haven't done any stress testing yet but I can do all normal activities without restriction or pain. I cleaned the bathroom floor yesterday and it wasn't even hard. Couple months ago I would have simply laughed at the very idea. And my knees have improved so much I can go up and down stairs without even holding on to the rail, and even carrying stuff. My daughter has a congenital back condition that gives her significant pain just from walking around Costco. Started her on boron and she's now very much improved too. After the first post-boron trip through Costco I asked her, the following day, if she had had much pain. Normally I would see her leaning against stuff or squatting down, and when it was time to move again there was real discomfort on her face straightening back up, and I hadn't noticed any that trip. She paused for a moment, then looked up at me and said, "I didn't even think about it." Boron is a straight-up miracle for joint pain.
What dose are you taking?
 

Nokoni

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Nokoni

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injected corticosteroid dissolves cartilage, delays healing and makes things much worse.
When I got my injection I couldn't move so much as my arm without sharp, breathtaking agony. Had been that way for a week, maybe two or three. How does it heal when every breath damages it again? Gotta get the inflammation down for healing to even begin. That injection – the only one I ever got – allowed me to get back to work and gave me at least another decade of relatively normal functionality. I thank God for that injection. Is the treatment overused? Seems pretty likely. But in certain circumstances, it's fantastic.
 
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Good for you!

I haven’t seen too many outcomes like yours. I have seen more and more injections more frequently as the joints dissolve away.
 

oburns

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I got such a steroid injection once for a ruptured disk. The relief was fantastic and almost immediate but, of course, temporary. That was 15 or 20 years ago and since then my back had become so unstable that much of the time I was unable to take proper care of my pets, or even to tie my shoes. A month or two ago I discovered boron (borax) and my back now feels quite solid. Haven't done any stress testing yet but I can do all normal activities without restriction or pain. I cleaned the bathroom floor yesterday and it wasn't even hard. Couple months ago I would have simply laughed at the very idea. And my knees have improved so much I can go up and down stairs without even holding on to the rail, and even carrying stuff. My daughter has a congenital back condition that gives her significant pain just from walking around Costco. Started her on boron and she's now very much improved too. After the first post-boron trip through Costco I asked her, the following day, if she had had much pain. Normally I would see her leaning against stuff or squatting down, and when it was time to move again there was real discomfort on her face straightening back up, and I hadn't noticed any that trip. She paused for a moment, then looked up at me and said, "I didn't even think about it." Boron is a straight-up miracle for joint pain.
Check out www.pendotion.com
 

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