Khaberni - A recent clinical trial conducted in China revealed that injecting glucocorticoid (cortisone) into the fat pad below the patella does not significantly alleviate knee pain or reduce inflammation associated with inflammatory joint arthritis, compared to saline injections, over a 12-week follow-up period, according to a report on the scientific site "MedicalXpress".
According to the study published in the JAMA Network Open journal, this type of injection, which was proposed as a potential treatment option to directly target inflammation sites, did not show statistically significant superiority over the placebo, despite the widespread use of cortisone injections inside the joints as a means of pain relief.
Osteoarthritis is one of the most prevalent chronic diseases worldwide, affecting approximately 595 million people, with knee joints being among the most affected areas. This disease is associated with reduced mobility, decreased quality of life, and higher mortality rates among the elderly, in the absence of curative treatments, especially with increasing rates of obesity and an aging population.
It is known that some cases of knee osteoarthritis are accompanied by inflammation, involving adjacent tissues such as the synovial membrane of the joint and the fat pad below the patella, tissues that play a significant role in sustaining the inflammation. Furthermore, fluid accumulation inside the joint, along with swelling of the synovial membrane—a condition known as synovitis—afflicts more than 46% of patients, and is linked to increased pain severity, accelerated cartilage damage, and a higher likelihood of undergoing joint replacement surgery.
The study included 60 patients at four medical centers in China, who underwent a randomized double-blind trial, where some received an ultrasound-guided cortisone injection into the fat pad, while others received a saline injection, with regular follow-ups during 12 weeks.
The results showed that pain severity gradually decreased in both groups, yet the difference between them was not statistically significant. No significant difference was recorded in the size of synovitis measured by MRI, nor in quality of life indicators or the need for pain relievers. On the other hand, a slight improvement was noted in the cartilage damage indicators in the cortisone group, although this did not reflect on clinical symptoms.
Researchers concluded that cortisone injections into the fat pad below the patella do not provide any tangible improvement in pain or inflammation in the short term, emphasizing the need for longer-term studies to evaluate the long-term structural effects, such as atrophy of the adipose tissue or loss of cartilage.
These findings highlight the need to re-evaluate some common treatment practices and explore more effective and safer strategies for dealing with the increasing global burden of knee osteoarthritis.
