504 Limited evidence for intra-articular corticosteroids in knee osteoarthritis

June 03, 2017

written by Brian R McAvoy

Clinical question
How effective are intra-articular corticosteroids (IACs) in people with knee osteoarthritis (OA)?

Bottom line
Compared with sham or no intervention, IACs may result in a moderate improvement in pain and a small improvement in physical function measured at 1–6 weeks. The effects decreased over time, and there was no evidence an effect remained after 6 months. Those receiving IACs as treatment had a similar number of side effects as those receiving placebo, but the information was neither precise nor reliable.


Most of the studies were small and hampered by low methodological quality. A single trial described adequate measures to minimise biases, and did not find any benefit from IACs.

Knee OA is a leading cause of chronic pain, disability and decreased quality of life. Despite the long-standing use of IACs, there is ongoing debate about their benefits and safety.

Cochrane Systematic Review
Juni P et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Reviews, 2015, Issue 10. Art. No.: CD005328.DOI: 10.1002/14651858. CD005238.pub3. This review contains 27 studies involving 1767 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.