Glicocorticóide intra-articular traz poucos benefícios para dor relacionada à osteoartrose de joelho e uso repetido acelera perda de massa cartilaginosa.

Glicocorticóide intra-articular traz poucos benefícios para dor relacionada à 

osteoartrose de joelho e uso repetido acelera perda de massa cartilaginosa.

Lack of benefit of intraarticular glucocorticoid injections for knee osteoarthritis

Although limited evidence suggests that intraarticular glucocorticoid injections for knee osteoarthritis (OA) may result in short-term pain relief, data for longer-term outcomes are less favorable. A randomized trial including 140 patients with symptomatic knee OA and ultrasound features of synovitis found that pain reduction was no different comparing injections of 40 mg triamcinolone acetonide with placebo every 12 weeks for two years [1]. Furthermore, two years of triamcinolone injections resulted in greater cartilage volume loss. These findings do not support intraarticular glucocorticoid injections in patients with symptomatic knee OA and are consistent with our practice. In addition, we discourage the use of serial injections (eg, every three months) due to progressive cartilage damage in knee OA patients.

See 'Management of moderate to severe knee osteoarthritis', section on 'Intraarticular glucocorticoid injection'.

1. McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA 2017; 317:1967.