Long-term efficacy and safety of intra-articular corticosteroid injections in patients with knee osteoarthritis

INTRODUCTION: Knee osteoarthritis (KOA) is a highly prevalent condition worldwide, resulting in a significant symptom burden and diminished quality of life. Mainstays of KOA management include weight loss, exercise, physical activity, and simple analgesia, with joint replacement as a last resort. Intra-articular injections, especially corticosteroids, have been increasingly used to provide symptomatic relief when simple analgesia fails. However, the efficacy and safety of intra-articular corticosteroid injections (IACS) remain poorly established. AREAS COVERED: This narrative literature review will evaluate the current available literature, outlining evidence on the use of IACS in KOA as well as its clinical efficacy, safety, adverse effects and potential alternative injections. Articles included were sourced from the University of Sydney Library database, Medline via Ovid, and Scopus, between 2000 and 2026. EXPERT OPINION: Overall, while IACS may only provide short-term pain relief, evidence suggests that long-term use should be avoided to prevent chondrotoxicity and further progression of osteoarthritis.