THE EFFECTIVENESS OF INTRA-ARTICULAR INJECTIONS FOR KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Introduction: Intra-articular (IA) injections have been used to reduce knee osteoarthritis (OA) pain. However, several side effects following the injections were reported and raised the question of whether IA injections were effective and safe. Hence, this study aimed to identify the most common type of IA injections used in treating knee OA and to determine its effectiveness, duration of pain relief and most common side effects. Methods: Online literature searches on PubMed, Wiley Online Library, and Cochrane Library were performed by using the keywords "intra-articular injection" AND "knee osteoarthritis" OR "knee OA" AND "randomised controlled trial" OR "RCT". Only randomised controlled trial studies that analysed the effects of intra-articular injections for knee OA patients and published in English were included. A total of 2823 articles were identified, 22 full-text articles were assessed, and six articles have been included in this study. National Institutes of Health (NIH) Quality Assessment Tools were used to evaluate the risk of bias in these six articles, and only four articles were included for meta-analysis. Results: The present data showed that intra-articular hyaluronic acid injection was the most common type of IA injection. However, only intra-articular corticosteroid injections (IACI) are effective for knee OA treatment. The pain relief duration provided by each intra-articular injection type varies between 1 month to 6 months. Side effects such as arthralgia and joint swelling were recorded following the administration of IA hyaluronic acid injection and IA stem cell injection, but not in the IACI therapy groups. Conclusion: Although IACI has been shown to reduce pain in patients with knee OA, the long-term consequences of IACI therapy in this population have yet to be confirmed.