Effect of Intraarticular Steroids on Bone Turnover in Osteoarthritis

Oral and nasal steroids may enhance osteoporosis by suppressing bone formation. Intra-articular steroids may also suppress bone formation, however, the duration or relationship to a steroid dose has not been established. It is hypothesized that intra-articular steroids suppress bone formation transiently, returning to pretreatment levels within four weeks in subjects with osteoarthritis. The purpose of the study is to determine if intra-articular steroids suppress markers of bone formation or resorption in osteoarthritis patients and whether these markers may be modified by Vitamin D or Dual-energy X-ray absorptiometry (DEXA) bone density status

Inclusion criteria

• Age > 40 years
• Male or postmenopausal female
• Diagnosis of knee osteoarthritis
• DEXA bone density done within the past 12 months
• Painful knee, visual analogue scale (VAS) > 4 of (10=worst)

Exclusion criteria

• Diabetes Mellitus Type I or II
• Systemic inflammatory illness
• Systemic infections which may be aggravated by steroid therapy
• No current or previous (< 3 years) biphosphate therapy
• Previous knee replacement surgery
• No current or previous Parathyroid hormone (PTH) therapy