New research suggest that steroid treatment for osteoarthritis knee suffers may not progress disease as previously thought

Steroid treatment for osteoarthritis knee suffers was thought to progress the disease, but that belief has been overturned following a review of the literature by researchers at The University of Auckland.

Associate-Professor Bruce Arroll, from the School of Population Health at the University, says that osteoarthritic knee pain is one of the leading causes of disability amongst older people.

"Previously it was thought that you could give sufferers about 20 mgs of the steroid cortisone (prednisone) for a couple of weeks, but that it promotes disease progression if it is used any longer."

"From reviewing all the hospital-based research, we have found that there was no evidence that cortisone progresses the disease. In fact, it provides an effective pain relief for up to five months particularly if the dose is increased to between 40 and 120mgs," Dr Arroll says.

There is no cure, other than surgical joint replacement, for knee osteoarthritis, but Dr Arroll says the study gives hope of pain relief for sufferers.

"Our finding that giving steroids is effective for longer periods means that knee replacements won't be needed so urgently. The injections will enable people to walk, be more comfortable and have less trouble from their knees," he says.

The study, commissioned by the Accident Rehabilitation and Compensation Insurance Corporation, was co-authored by Dr Arroll and Dr Felicity Goodyear-Smith from The University of Auckland and was published this month in the British Medical Journal.

Dr Arroll says surgeons and doctors are already showing an interest in the work.

"Another concern that was raised in the past by surgeons is that treatment could weaken the joints and therefore make joint replacement surgery less effective. But none of the research supports that, so it seems that cortisone will not have a negative effect on later surgery," he says.

Dr Arroll says it is the first time a review of research into cortisone treatment for osteoarthritis of the knee has been undertaken. He says future research into the area is needed, which would include longer studies that look at the impact of higher doses of cortisone.

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