To assess the efficacy of glucocorticoid injections into the infrapatellar fat pad (IPFP) for reducing knee pain and effusion synovitis volume in patients with inflammatory knee osteoarthritis.
Key Findings:
Mean VAS pain reduction was 39.3 mm in the treatment group vs. 31.4 mm in the placebo group, with a non-significant difference of 7.9 mm.
No significant differences in effusion synovitis volume reductions between groups.
Post hoc analyses showed greater improvement in Western Ontario and McMaster Universities Osteoarthritis Index pain scores for the glucocorticoid group.
MRI assessments indicated a statistically significant reduction in cartilage defect scores in the treatment group.
Interpretation:
While primary endpoints were not met, some secondary outcomes favored glucocorticoid injections, indicating potential benefits that warrant further investigation.
Limitations:
Modest sample size and short follow-up period of 12 weeks.
Use of non–contrast-enhanced MRI.
Concomitant hyaluronic acid injections may have amplified placebo effects.
Findings may not generalize to noninflammatory OA phenotypes.
Conclusion:
Glucocorticoid injections into the IPFP did not significantly alleviate pain or reduce effusion synovitis volume over 12 weeks in knee OA patients, but post hoc findings suggest further research is needed.
