40天內接受六次類固醇關節內注射一個月後的關節鏡發現大量軟骨殘骸-一案例報告
Intra-articular steroid injections are used to treat painful swelling knee joints with arthritis sometimes. The steroid is injected directly into the painful joint. The injection usually relieve pain and make movement easier. The benefit can last for several months. But steroid may cause surface degeneration on cartilage especially by malpractice.
A 63 years old female received her right knee recorded arthroscopy one month after the last intra-articular steroid injection. She had received 6 intra-articular steroid injections in 40 days previously. Routine knee arthroscopy was done. Massive wreckage of cartilage showed accumulated tiny pieces of loose bodies. Also noted continue bare area with exposed subchondral bone on medial femoral condyle. Her subchondral bone of the bare area was noted more fragile. But fully fine cartilage of femoral trochlea was also noted.
3 years ago patient had received her left knee arthroscopy by me. At that time, her left knee didn’t have such bizarre phenomenon.
After arthroscopy, she still bothered by joint pain at daily activity. So non-weight bearing was instructed as the usual protocol of tibial plateau fracture.
Such disease caused patient a lot distress. She couldn’t enjoy funny activities with her family including her granddaughter. Her loss of irreparable massive femoral cartilage and steroid induced further aching bone made a lot trouble clinically.
The pro and cons of intra-articular steroid injection is held in physician’s hand. Clinical application of intra-articular steroid injection should be managed more cautiously.
