Akademik Veri Yönetim Sistemi
RADIOLOGY, cilt.315, sa.2, 2025 (SCI-Expanded, Scopus)
Background: At least 10% of all patients with knee osteoarthritis (OA) undergo treatment with injectable corticosteroids or hyaluronic acid (HA). Although both have been shown to help with symptomatic pain relief, their long-term effects on knee OA progression remain inconclusive. Purpose: To investigate the association between intra-articular knee injections, specifically corticosteroids and HA, and OA progression using a detailed whole-joint semiquantitative MRI evaluation and clinical outcomes for a period of 2 years. Materials and Methods: This secondary analysis uses data from the Osteoarthritis Initiative (OAI), a multicenter, longitudinal, prospective study (February 2004 to January 2015). Participants who received a reported injection of corticosteroid or HA and propensity-score-matched controls (on age, sex, body mass index [calculated as weight in kilograms divided by height in meters squared], and clinical variables) were analyzed. Using the Whole-Organ MRI Score (WORMS) system for cartilage, bone marrow lesions, and meniscus, 3-T MRI performed at the time of injection, 2 years prior, and 2 years after were semiquantitatively graded. Postinjection progression was quantified using WORMS difference between time of injection and the 2-year follow-up. Associations with injection type were analyzed using repeated measures of analysis of covariance. Results: There were 210 participants analyzed (mean age, 64 years +/- 7.9 years [SD]; 126 female participants). Corticosteroids were associated with greater WORMS progression compared with controls (mean difference, 0.39; 95% CI: 0.05, 0.75; P = .02) and HA (0.42; 95% CI: 0.01, 0.84; P = .04). HA was associated with decreased WORMS progression compared with the injection-concurrent time frame (mean difference, -0.42; 95% CI: -1.34, -0.28; P = .003). Both corticosteroids (mean difference in Western Ontario and McMaster Universities Osteoarthritis Index scores, -5.20; 95% CI: -6.91, -3.48; P = .001) and HA injections (-2.15; 95% CI: -4.42, -0.13; P = .04) were associated with reduced pain after injection. Conclusion: Corticosteroid injections were associated with higher OA progression than HA injections and controls, whereas HA was associated with decreased progression at MRI for up to 2 years after injection.