Intra-articular Knee Steroid Injections Efficiency in Stage 3-4 Gonarthrosis


  • Alkan Bayrak
  • Sünkar Kaya Bayrak
  • Altuğ Duramaz
  • Cenk Sahan
  • Ahmet Büyükhatipoğlu
  • Furkan Çağlayan Aslantaş

Received Date: 08.12.2017 Accepted Date: 16.01.2018 Med J Bakirkoy 2018;14(4):372-376


Gonarthrosis is a chronic non-inflammatory, degenerative disease that starts with joint pain, movement limitation, as a result of joint cartilage damage in the knee joint. In gonarthrosis, patient education, rest, preventive measures, pharmacological, physical therapy and surgical treatment methods can be used alone or together according to the stages of the disease. Intra-articular injections are used to reduce pain and increase functional movements in gonarthrosis. The aim of this study is to evaluate the effect of intra-articular knee steroid injection on the knee pain.

Materials and Methods:

A total of 151 knees from 108 patients who were admitted to the orthopedics clinic with long-lasting knee pain and who had radiological grade 3-4 gonarthrosis according to the Kellgreen-Lawrence classification were included in the study. Pain scores were compared according to the Visual Analogue scale (VAS) and Verbal Category scale (VCS) before the injection and at 6-week post injection. Combination of 9 ccs 2% prilocaine and 1 cc triamcinolone hexacetonide injection was applied intra-articular.


A total of 151 knees from 101 patients aged between 48 to 88 (67.49±8.99) (F=77, M=31) were included. Of the cases, 55.6% (n=84) right and 44.4% (n=67) left knee were injected; 29.8% (n=45) were stage 3 and 70.2% (n=70.2) were stage 4. Pre-injection VAS score was 8.34±0.75, the VCS was 4.29±0.48; post-injection VAS score was 3.68±1.59, and VCS was 2.22±0.8 (p<0.001).


Different treatment options are applied according to the stage of knee osteoarthritis. Intra-articular injections, physiotherapy and non-steroid anti-inflammatory drugs are commonly used conservative treatment modalities. Steroids and hyaluronic acid derivatives can be administered separately or together at intra-articular knee injections. Intra-articular knee injections are preferred in combination treatment of early-stage gonarthrosis due to rapid pain relief and replicable. Intra-articular knee steroid injections suggested for patients who don’t consider the surgery or want to save time.

Keywords: Steroid, intra-articular injection, VAS score

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