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Results of a fairly recent randomized trial raised concern about intra-articular steroids' effects on knee structure: Patients with symptomatic knee osteoarthritis (OA) who received intra-articular steroids every 3 months for 2 years lost more cartilage thickness than did placebo recipients (NEJM JW Gen Med Jul 1 2017 and JAMA 2017; 317:1967). To address this concern, researchers analyzed data from a prospective French cohort study of 656 patients with knee OA.
During 5 years, 8% of patients had steroid injections (mean, 2 injections), 15% had hyaluronic acid injections, 14% had both, and 63% had neither. In analyses adjusted for various confounding variables, no significant differences were found between groups in the incidence of total kne…