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Abstract
The knee joint is typically described as a modified hinge because its motion is more complex than simple flexion extension. The knee is one of the weight bearing joint, of the body, its nature makes it very liable to many traumatic and pathological disorders.
OA is the most common pathological disorder affecting the knee specially in middle and old age.
Osteoarthritis is defined as an inherently non inflammatory disorder of movable joints characterized by deterioration of articular cartilage and by the formation of new bone at the joint surfaces and margins. The relationship between cartilaginous and bony changes equalize the pathologic changes seen in OA.
OA is characterized by a slow degradation of cartilage over several years. In normal cartilage, a delicate balance exists between matrix synthesis and degradation; in OA, however, cartilage degradation exceeds synthesis. The balance between synthesis and degradation is affected by age and is regulated by several factors produced by the synovium and chondrocytes, including cytokines, growth factors, aggrecanases, and MMPs.
The use of intra-articular (IA) injections to treat osteoarthritis dates back to the 1930s. Faced with a local articular problem, physicians logically proposed various intra-articular treatments, directly injected close to the cartilage lesions and synovial membrane in order to improve symptoms and eventually to delay or stop disease progression.
Corticosteroid injections are widely used for symptomatic treatment of osteoarthritis of peripheral joints, especially the knee joint. Injections are mostly intra-articular, sometimes periarticular.