Deleterious Effect of Intra-Articular Hydrocortisone

Chandler, G.N.; Wright, V.

doi:10.1016/s0140-6736(58)92262-1

Cited by 168 publications

(34 citation statements)

References 3 publications

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“…All our patients were on some form of drug therapy, including a wide range of analgesic, anti-inflammatory, and anti-rheumatic drugs, and it was not possible to control for the possible effects of these agents on cartilage metabolism. However, because of the known inhibitory effects of steroids on chondrocytes metabolism (35,36), patients who had received a local steroid injection to the index knee within the last three months were excluded.…”

Section: Discussionmentioning

confidence: 99%

Changes in cartilage metabolism in arthritis are reflected by altered serum and synovial fluid levels of the cartilage proteoglycan aggrecan. Implications for pathogenesis.

Poole¹,

Ionescu²,

Swan³

et al. 1994

J. Clin. Invest.

162

112

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The metabolism of the cartilage proteoglycan aggrecan was studied in patients with osteoarthritis (OA, n = 83), rheumatoid arthritis (RA, n = 127), and in controls (n = 117) using monoclonal antibody-based radioimmunoassays for glycosaminoglycans in the serum and synovial fluid (SF) to detect epitope 846 on chondroitin sulfate (probably only on recently synthesised molecules) and a keratan sulfate (KS) epitope AN9PI, present on intact and degraded molecules.Epitope 846 levels were always elevated in SF over serum (mean 38-fold in OA and 8.6-fold in RA) being highest in OA patients with the longest disease duration and greatest loss of cartilage, and lowest in RA joints with high leucocyte counts. Serum levels were more often elevated in RA (56%) than in OA (19%) and probably reflect increased aggrecan synthesis in diseased joints. KS levels were higher in SF than in serum in 69% of patients (up to 2.3-fold); levels were inversely (OA) and directly (RA) related to SF leucocyte counts. Serum KS was reduced in both diseases and in RA was inversely related to both systemic and joint inflammation markers. SF 846 levels were inversely related to SF KS in both diseases.These epitopes may provide a measure of the balance between cartilage synthesis and degradation in these diseases. (J. Clin. Invest. 1994. 94:25-33.) Key words: cartilage aggrecan rheumatoid arthritis osteoarthritis

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Section: Discussionmentioning

confidence: 99%

Changes in cartilage metabolism in arthritis are reflected by altered serum and synovial fluid levels of the cartilage proteoglycan aggrecan. Implications for pathogenesis.

Poole¹,

Ionescu²,

Swan³

et al. 1994

J. Clin. Invest.

162

112

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“…Gradually, however, various complications began to be noticed, first infections and their sequelae, but more important still are the degenerative conditions which may develop in such a cortisone-treated joint. Chandler et al, in 1958, I%-ported Charcot-like changes in a hip joint treated with local injections of hydrocortisone acetate, and others have subsequently published similar findings (Chandler & Wright 1958, Swe,etnam et al 1960, and Steinberg et al 1962. The author will report a few of her own cases which illustrate these changes and thereafter, on the basis of the previous and present experience, try to arrive at an acceptable explanation by considering the essential mechanism of the effect of these hormones.…”

Section: Introductionmentioning

confidence: 83%

Deleterious Effects of Corticosteroids Administered Topically, in Particular Intra-Articularly

Zachariae

1965

Acta Orthopaedica Scandinavica

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“…Salient findings are that the number of intra-articular corticosteroid injections received appears to correlate both with more severe disease at the time of arthritis surgery 45 and with radiographic acceleration in joint deterioration. 46 Complications associated with corticosteroid injection treatment of athletic injuries and of nonathletic injury medical conditions are comparatively listed in Tables 2 and 5, respectively. Tendon rupture is the predominant complication reported in the athletic injury corticosteroid injection treatment groups, whereas systemic adverse effects occur more commonly in the nonathletic injury series.…”

Section: Discussionmentioning

confidence: 99%

Complications Associated With the Use of Corticosteroids in the Treatment of Athletic Injuries

Nichols¹

2005

Clinical Journal of Sport Medicine

199

153

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This critical review reveals that the existing medical literature does not provide precise estimates for complication rates following the therapeutic use of injected or systemic corticosteroids in the treatment of athletic injuries. Tendon and fascial ruptures are often reported complications of injected corticosteroids, whereas tibial stress fractures and multifocal osteonecrosis were described with systemic corticosteroids.

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Deleterious Effect of Intra-Articular Hydrocortisone

Cited by 168 publications

References 3 publications

Changes in cartilage metabolism in arthritis are reflected by altered serum and synovial fluid levels of the cartilage proteoglycan aggrecan. Implications for pathogenesis.

Changes in cartilage metabolism in arthritis are reflected by altered serum and synovial fluid levels of the cartilage proteoglycan aggrecan. Implications for pathogenesis.

Deleterious Effects of Corticosteroids Administered Topically, in Particular Intra-Articularly

Complications Associated With the Use of Corticosteroids in the Treatment of Athletic Injuries

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