If you have knee osteoarthritis, you know how frustrating and debilitating the pain can be. Thankfully, there are a variety of treatment options available to help manage symptoms, including glucocorticoid injections. However, there is some debate among physicians about the safety of intra-articular (IA) glucocorticoid injections, which are administered directly into the knee joint. An alternative approach is intramuscular (IM) glucocorticoid injection, which is injected into the muscle. But which is more effective?
A recent clinical trial, known as the KIS trial, sought to answer this question. The trial involved 145 patients with symptomatic knee osteoarthritis and was conducted in 80 primary care general practices in the southwest of the Netherlands. Patients were randomly assigned to receive either an IM injection of the glucocorticoid triamcinolone acetonide in the ipsilateral ventrogluteal region or an IA injection in the knee joint. All patients were followed up for 24 weeks.
The trial found that clinically relevant improvements in knee pain were reached up to 12 weeks after both types of injection. However, at 4 weeks, the estimated mean difference in the Knee Injury and Osteoarthritis Outcome Score between the two groups was -3.4, indicating that IM injection may be inferior to IA injection in reducing pain at this time point. However, at 8 and 24 weeks after injection, IM injection was found to be non-inferior to IA injection.