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Inflammation probably plays a role in osteoarthritis (OA), and some evidence suggests that this inflammation can lead to progressive cartilage loss. Corticosteroid injections have been evaluated for managing OA of the knee, and an earlier report suggested that injections every 3 months are safe (Arthritis Rheum 2003; 48:370), even though steroids have antianabolic effects on healthy cartilage.
In this 2-year, double-blind U.S. clinical trial, 140 patients (mean age, 58) with symptomatic knee OA and ultrasound-demonstrated effusion and synovitis were randomized to intra-articular injections of triamcinolone or placebo every 3 months. At 2 years, triamcinolone patients exhibited significantly greater loss in cartilage thickness (mean, 0.2 mm v…