Osteoarthritis of the knee and the hip are two of the most common joint diseases among adults. The damage to the joint’s cartilage causes pain and restricts mobility. One treatment of knee and hip osteoarthritis entails administering injections of glucocorticoids (steroid hormones) into the joint. This report investigates the safety and the efficacy of this treatment method, together with its cost/benefit ratio, its impact on cost budgets and further ethical, legal, societal and organisational issues and concerns.
To determine the efficacy of this treatment, the investigation analysed the movement functions, the pain levels, the quality of life as a result of the condition and the use of care services among study subjects. The data used for this were drawn from 16 studies of knee osteoarthritis covering 1,522 participants and four studies of hip osteoarthritis covering 239 participants. For both conditions, the investigation concluded that the use of glucocorticoid injections produced no major improvement in the subject’s condition three months after administration compared to sham treatment or no treatment at all. Both study groups showed some pain relief one month after injection. And the subjects with knee osteoarthritis who had received the injection made less use of care services. On the ethical and societal issues front, the investigation’s conclusions emphasised above all the importance of ensuring that patients are adequately informed about the benefits of movement and weight loss in alleviating their condition. The investigation’s economic modelling showed that glucocorticoid injections into the joint may be a cost-effective treatment approach. For knee osteoarthritis patients, the additional costs per year of life in full health gained amounted to CHF 12,456. The impact of such glucocorticoid injection treatments on cost budgets was estimated at CHF 0.82 million in 2025 rising to CHF 0.97 million in 2029 for knee treatments, and at CHF 0.52 million in 2025 rising to CHF 0.57 million in 2029 for hip treatments.
The report concludes that the benefits of glucocorticoid injection treatment after three months could not be demonstrated, but improvements after one month could be seen. Given the size of the data corpus used, it is unclear whether the benefits observed could be extrapolated to the entire population.
