Cortisone Injections and Knee Health: A Comprehensive Analysis

Cortisone, a steroid hormone naturally produced by our adrenal glands, plays a crucial role in reducing inflammation and pain when administered as a medication. This article delves into its application in treating various conditions such as knee osteoarthritis, while also addressing the concerns regarding its potential side effects, particularly the degradation of knee cartilage.
An injection being inserted into the knee.

Overview

Understanding Knee Cartilage

The knee cartilage is a resilient tissue covering the ends of bones within a joint. Along with the meniscus, it acts as a shock absorber and facilitates smooth bone movement.

It is vital for knee functionality but is susceptible to damage from injuries or diseases like osteoarthritis.

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Cortisone injections

Cortisone injections are a common treatment for knee osteoarthritis. These injections can provide short-term pain relief and reduce inflammation in the knee joint.

While the short-term benefits to inflammation and pain reduction are well-known, their long term effects are questionable.

A Cochrane review which analyzed 27 trials with approximately 1800 participants found that it is unclear whether there are any benefits for osteoarthritis after one to six weeks since corticosteroid injection [1].

Adverse affects

Some studies suggest that cortisone injections may also have serious negative effects.

A study in The Bone and Joint Journal from 2020, which followed approximately 4000 patients who were at risk of osteoarthritis, found that patients who received corticosteroids were 6 times more likely to have total knee replacement than those who did not [2].

However, it is important to note that these patients already had a heightened osteoarthritis risk prior to the injections.

The study, also found that each injection increased the absolute risk of knee replacement by 9.4% at a follow-up of 9 years [2]. Several other studies have also found detrimental effects of corticosteroid injections to knee cartilage, especially at high doses and long durations [3], [4], [5].

The scientific literature has conflicts on how serious and frequent the adverse effects are. Some studies, say that the adverse effects of corticosteroid injections are either rare or insignificant [6].

Other than adverse effects on the knee cartilage, corticosteroids have also been found to influence levels of cortisol (a hormone related to stress) and blood glucose [7].

Conclusion

In conclusion, cortisone injections have well-documented short-term benefits such as inflammation and pain reduction. There is some evidence to suggest that cortisone injections do not have long-term benefits and may have serious adverse effects, such as knee cartilage degradation. However, the scientific literature has conflicts on how serious and frequent these adverse effects are. Patients with knee osteoarthritis who are considering cortisone injections should study and discuss the potential risks and benefits with a qualified professional before making a decision.

Disclaimer

This article was not written by a medical professional and does not offer health advice. The purpose of this article is to demonstrate the usage of MediSearch, an AI-powered search engine, providing science-based answers to medical queries. Always consult a medical professional regarding your condition.

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