Arroll Bruce, Goodyear-Smith Felicity
Department of General Practice and Primary Health Care, School of Population Health University of Auckland, Private Bag 92019 Auckland.
BMJ. 2004 Apr 10;328(7444):869. doi: 10.1136/bmj.38039.573970.7C. Epub 2004 Mar 23.
To determine the efficacy of intra-articular corticosteroid injections for osteoarthritis of the knee and to identify numbers needed to treat.
Cochrane controlled trials register, Medline (1966 to 2003), Embase (1980 to 2003), hand searches, and contact with authors.
Randomised controlled trial in which the efficacy of intra-articular corticosteroid injections for osteoarthritis of the knee could be ascertained.
In high quality studies, the pooled relative risk for improvement in symptoms of osteoarthritis of the knee at 16-24 weeks after intra-articular corticosteroid injections was 2.09 (95% confidence interval 1.2 to 3.7) and the number needed to treat was 4.4. The pooled relative risk for improvement up to two weeks after injections was 1.66 (1.37 to 2.0). The numbers needed to treat to get one improvement in the statistically significant studies was 1.3 to 3.5 patients.
Evidence supports short term (up to two weeks) improvement in symptoms of osteoarthritis of the knee after intra-articular corticosteroid injection. Significant improvement was also shown in the only methodologically sound studies addressing longer term response (16-24 weeks). A dose equivalent to 50 mg of prednisone may be needed to show benefit at 16-24 weeks.
确定关节腔内注射皮质类固醇治疗膝关节骨关节炎的疗效，并确定所需治疗人数。
Cochrane对照试验注册库、Medline（1966年至2003年）、Embase（1980年至2003年）、手工检索以及与作者联系。
可确定关节腔内注射皮质类固醇治疗膝关节骨关节炎疗效的随机对照试验。
在高质量研究中，关节腔内注射皮质类固醇后16 - 24周膝关节骨关节炎症状改善的合并相对风险为2.09（95%置信区间1.2至3.7），所需治疗人数为4.4。注射后两周内改善的合并相对风险为1.66（1.37至2.0）。在具有统计学意义的研究中，获得一次改善所需治疗的患者人数为1.3至3.5人。
有证据支持关节腔内注射皮质类固醇后短期内（长达两周）膝关节骨关节炎症状有所改善。在仅有的针对长期反应（16 - 24周）且方法学合理的研究中也显示出显著改善。在16 - 24周时可能需要相当于50毫克泼尼松的剂量才能显示出疗效。
