Effect of Intramuscular vs Intra-articular Glucocorticoid Injection on Pain Among Adults With Knee Osteoarthritis (Part 2)

In the treatment of osteoarthritis (OA) intramuscular (IM) injection could be an alternative approach for glucocorticoid administration on patients with knee OA.

This is because it eliminates the direct risks of toxic effects on cartilage and septic arthritis and is easier to perform than intra-articular (IA) glucocorticoid injection.

 Intramuscular glucocorticoid injection has been reported to be beneficial in relieving pain in other musculoskeletal diseases, such as rotator cuff disease and hand OA.

In a double-blind trial conducted by our team, IM glucocorticoid injection was superior to placebo injection for reducing pain in patients with hip OA up to at least 12 weeks.

To my knowledge, no study has evaluated the analgesic effect of IM glucocorticoid injection for knee OA or directly compared its effect with IA glucocorticoid injection.

Therefore, a randomized clinical trial was done to assess the effectiveness of IM glucocorticoid injection in patients with symptomatic knee OA in primary care, compared with standard IA glucocorticoid injection.

The primary objective was to investigate whether an IM injection is noninferior to the IA injection in reducing knee pain at 4 weeks after injection.

Next week we will be making a deeper dive in the methods and process of the clinical trial in our next issue.