{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T13:25:27Z","timestamp":1793712327632,"version":"4.6.1"},"reference-count":44,"publisher":"The Journal of Rheumatology","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>We examined the longterm effectiveness of corticosteroid or hyaluronic acid injections in relieving symptoms among persons with knee osteoarthritis (OA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Using Osteoarthritis Initiative data, a new-user design was applied to identify participants initiating corticosteroid or hyaluronic acid injections (n = 412). Knee symptoms (pain, stiffness, function) were measured using The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). We used marginal structural models adjusting for time-varying confounders to estimate the effect on symptoms of newly initiated injection use compared to nonusers over 2 years of followup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Among 412 participants initiating injections, 77.2% used corticosteroid injections and 22.8% used hyaluronic acid injections. About 18.9% had additional injection use after initiation, but switching between injection types was common. Compared to nonusers, on average, participants initiating a corticosteroid injection experienced a worsening of pain (yearly worsening: 1.24 points, 95% CI 0.82\u20131.66), stiffness (yearly worsening: 0.30 points, 95% CI 0.10\u20130.49), and physical functioning (yearly worsening: 2.62 points, 95% CI 0.94\u20134.29) after adjusting for potential confounders with marginal structural models. Participants initiating hyaluronic acid injections did not show improvements of WOMAC subscales (pain: 0.50, 95% CI \u22120.11 to 1.11; stiffness: \u22120.07, 95% CI \u22120.38 to 0.24; and functioning: 0.49, 95% CI \u22121.34 to 2.32).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Although intraarticular injections may support the effectiveness of reducing symptoms in short-term clinical trials, the initiation of corticosteroid or hyaluronic acid injections did not appear to provide sustained symptom relief over 2 years of followup for persons with knee OA.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.171385","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T11:25:23Z","timestamp":1529061923000},"page":"1316-1324","source":"Crossref","is-referenced-by-count":32,"title":["Longterm Effectiveness of Intraarticular Injections on Patient-reported Symptoms in Knee Osteoarthritis"],"prefix":"10.3899","volume":"45","author":[{"given":"Shao-Hsien","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine E.","family":"Dub\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B.","family":"Eaton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey B.","family":"Driban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy E.","family":"McAlindon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate L.","family":"Lapane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2018,6,15]]},"reference":[{"key":"2018112909385986000_45.9.1316.1","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1002\/acr.21596","article-title":"American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee","volume":"64","author":"Hochberg","year":"2012","journal-title":"Arthritis Care Res"},{"key":"2018112909385986000_45.9.1316.2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-21-09-571"},{"key":"2018112909385986000_45.9.1316.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.01.003"},{"key":"2018112909385986000_45.9.1316.4","doi-asserted-by":"crossref","unstructured":"J\u00fcni P Hari R Rutjes AW Fischer R Silletta MG Reichenbach S Intra-articular corticosteroid for knee osteoarthritis. 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