The efficacy, accuracy and complications of corticosteroid injections of the knee joint

Abstract

Short-term symptomatic relief is the only evidence-based benefit of corticosteroid injection of an osteoarthritic knee. Accurate intra-articular placement is not achieved in up to 20% of injections and varies considerably with the anatomical approach used. There is no evidence that a medial approach is more accurate. The incidence of serious infectious complications following knee joint injections ranges widely, and may be as high as 1 in 3,000 and potentially far higher in high-risk patients for whom specialist management is advised.

Knee osteoarthritis in women

“…These injections can be helpful in combating painful flair ups but require invasive techniques, which can lead to complications, including infection. Difficulties in accuracy with intra-articular injections have been reported [33,34]. Corticosteroid injections in combination with local anesthetics are common and recent evidence suggests that these medications, though they relieve pain, may have chondrodestructive properties [35,36].…”

Effectiveness of Platelet-Rich Plasma in the Treatment of Moderate Knee Osteoarthritis

“…[4] Non-surgical interventions, such as corticosteroid injections, have a short duration, require repeat administration, and have potential for local and systemic side effects. [5,6] Therefore, there is a need for a noninvasive but effective treatment for knee OA.…”

Simultaneous bilateral septic arthritis of the knee after intraarticular steroid injection: A clinical report

“…[3] In rheumatoid patients on long-term immunosuppressive treatment, this raises to one in 2000 within 3 months of intraarticular injection. [4] Skin is the most common source of infection in rheumatoid patients, which accounts for 75% of the infection.…”

“…The incidence of septic arthritis of knee after intraarticular corticosteroid injection ranges from one in 3000 to one in 50,000 and may be higher in immunocompromised patients. [3] The treatment of iatrogenic septic arthritis necessitates multiple joint washout and debridement, long-term antibiotic therapy and prolonged inpatient hospital stay. A higher rate of infectious complications following intraarticular injection can be expected in immunocompromised patients.…”