Efficacy of intraarticular steroid injection in knee osteoarthritis using knee society score and visual analog score


  • Shriram Sampath Department of Orthopaedics Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
  • J. K. Giriraj Harshavardhan Department of Orthopaedics Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India




Osteoarthritis, Methylprednisolone acetate injection, Knee society score, Visual analog score


Background: Osteoarthritis of knee is a chronic degenerative joint disease which leads to pain, swelling, stiffness and decreased quality of life. The purpose of this study was to assess the effect of intra-articular steroid injection for osteoarthritis knee by using knee society score (KSS) and visual analog scale (VAS).

Methods: A prospective study of 38 patients (44 knees) diagnosed with osteoarthritis of knee were given 80mg of intra-articular methylprednisolone injection. The outcome was assessed using KSS and VAS before the injection and 3 months post injection.

Results: The mean VAS improved 3 months post injection whereas there was no improvement in the mean KSS. The scores of VAS 3 months post injection were statistically significant whereas the KSS scores were statistically insignificant compared with the pre injection values.

Conclusions: Intra-articular steroid injection for osteoarthritis of knee produces significant pain relief for most patients even in severe cases but this not translate to better functional outcomes.


Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;(2):CD005328.

Lluch E, Nijs J, Courtney C, Rebbeck T, Wylde V, Baert I et al. Clinical descriptors for the recognition of central sensitization pain in patients with knee osteoarthritis. Disabil Rehabil. 2018;40(23):2836-45.

Cooper C, Rannou F, Richette P, Bruyere O, Al-Daghri N, Altman RD, Brandi ML, et al. Use of intraarticular hyaluronic acid in the management of knee osteoarthritis in clinical practice. Arthritis Care Res. 2017;69:1287–96.

Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989 Nov;(248):13-4.

Leighton R, Åkermark C, Therrien R, Richardson J, Andersson M, Todman M et al. NASHA hyaluronic acid vs methylprednisolone for knee osteoarthritis: a prospective, multi-centre, randomized, non-inferiority trial. Osteoarthritis and Cartilage. 2014;22(1):17-25.

Dutta D, Ghosh S, Mukhopadhyay P, Mukhopadhyay S, Chowdhury S, Roy A. Efficacy and safety of low dose oral prednisolone as compared to pulse intravenous methylprednisolone in managing moderate severe Graves′ orbitopathy: A randomized controlled trial. Indian J Endocrinol Metab. 2015;19(3):351.

McCrum C. Therapeutic Review of Methylprednisolone Acetate Intra-Articular Injection in the Management of Osteoarthritis of the Knee - Part 1: Clinical Effectiveness. Musculoskeletal Care. 2016;15(1):79-88.

Raynauld J, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: A randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2003;48(2):370-7.

Wernecke C, Braun HJ, Dragoo JL. The effect of intra-articular corticosteroids on articular cartilage. Orthop J Sports Med. 2015;27: 2325967115581163.

Beyaz S. Comparison of efficacy of intra-articular morphine and steroid in patients with knee osteoarthritis. J Anaesthesiol Clin Pharmacol. 2012;28(4):496.

Henriksen M, Christensen R, Klokker L, Bartholdy C, Bandak E, Ellegaard K et al. Evaluation of the Benefit of Corticosteroid Injection Before Exercise Therapy in Patients With Osteoarthritis of the Knee. JAMA Intern Med. 2015;175(6):923-30.






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