14 May 2020

In The Bone & Joint Journal, RIHS researcher Stan Wijn et al. showed that patients with, or at risk of developing, symptomatic osteoarthritis of the knee were 1.57x more likely to undergo knee arthroplasty surgery after each corticosteroid injection they received in the knee joint.

Their findings were in line with previous studies that found a harmful effect of corticosteroid and suggest that a conservative approach regarding the treatment of these patients with corticosteroid injections should be recommended. The Bone and Joint Journal made a short clip of their findings and their publication got a lot of social media attention.

Abstract

Aims
Recent studies have suggested that corticosteroid injections into the knee may harm the joint resulting in cartilage loss and possibly accelerating the progression of osteoarthritis (OA). The aim of this study was to assess whether patients with, or at risk of developing, symptomatic osteoarthritis of the knee who receive intra-articular corticosteroid injections have an increased risk of requiring arthroplasty.

Methods
We used data from the Osteoarthritis Initiative (OAI), a multicentre observational cohort study that followed 4,796 patients with, or at risk of developing, osteoarthritis of the knee on an annual basis with follow-up available up to nine years. Increased risk for symptomatic OA was defined as frequent knee symptoms (pain, aching, or stiffness) without radiological evidence of OA and two or more risk factors, while OA was defined by the presence of both femoral osteophytes and frequent symptoms in one or both knees. Missing data were imputed with multiple imputations using chained equations. Time-dependent propensity score matching was performed to match patients at the time of receving their first injection with controls. The effect of corticosteroid injections on the rate of subsequent (total and partial) knee arthroplasty was estimated using Cox proportional-hazards survival analyses.

Results
After removing patients lost to follow-up, 3,822 patients remained in the study. A total of 249 (31.3%) of the 796 patients who received corticosteroid injections, and 152 (5.0%) of the 3,026 who did not, had knee arthroplasty. In the matched cohort, Cox proportional-hazards regression resulted in a hazard ratio of 1.57 (95% confidence interval (CI) 1.37 to 1.81; p < 0.001) and each injection increased the absolute risk of arthroplasty by 9.4% at nine years' follow-up compared with those who did not receive injections.

Conclusion
Corticosteroid injections seem to be associated with an increased risk of knee arthroplasty in patients with, or at risk of developing, symptomatic OA of the knee. These findings suggest that a conservative approach regarding the treatment of these patients with corticosteroid injections should be recommended. 

Publication
Intra-articular corticosteroid injections increase the risk of requiring knee arthroplasty.
Wijn SRW, Rovers MM, van Tienen TG, Hannink G.

 

Related news items


The new front line: big data podcast

22 May 2020

What role do big data and technology play in the fight against corona? What data can help save lives? How do you ensure that your personal health data is used safely? Among others, Peter-Bram 't Hoen explains.

read more

OARSI Basic Science Award for Peter van der Kraan

22 May 2020

Purpose of this Basic Science Award of the Osteoarthritis Research Society International (OARSI) is to stimulate fundamental research in the field of osteoarthritis.

read more

Evaluation of an AI system for detection of COVID-19 on Chest X-Ray images

22 May 2020

In the journal Radiology RIHS researcher Keelin Murphy described how an artificial intelligence system (CAD4COVID-XRay) can identify characteristics of COVID-19 on chest x-rays with performance comparable to six independent radiologists.

read more

First clinical trial with genetically modified malaria vaccine completed

22 May 2020

In an innovative study, Radboudumc and LUMC jointly tested a candidate vaccine based on a genetically weakened malaria parasite. The results of this clinical trial, published in Science Translational Medicine, show that the vaccine is safe and elicits a defense response against a malaria infection.

read more

New step in the development of a vaccine against malaria

22 May 2020

A new vaccine based on rodent malaria parasites achieved a 95% reduction in infection of the liver in humans. An international consortium publishes the results in Science Translational Medicine.

read more

Comenius Senior Fellowship for Jos Kole

12 May 2020

Assistant professor in Healthcare Ethics, Jos Kole received a Comenius Senior Fellowship, a prestigious educational scholarship for his plan ‘Physicians with character’. Aim of this scholarship is to innovate the Master of Medicine program.

read more