The Effect of Corticosteroid Doses on Pain in Knee Osteoarthritis: A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
OBJECTIVE: To evaluate the effect of various doses of intra articular corticosteroid injection (IACI) on pain reduction in knee osteoarthritis when compared with normal saline and perform a between-dose comparison. METHODS: A systematic review with meta-analysis was conducted searching four databases until April 2024. RCTs comparing the effect of IACI with normal saline on pain relief in knee osteoarthritis were included. The different doses were pooled into three categories: low (< 40 mg methylprednisolone equivalent), usual (40 mg), or high dose (> 40 mg). Their effect compared to normal saline was evaluated at very short (VST, 1-3 weeks), short (ST, 4-8 weeks) and middle term (MT, 10-16 weeks). A multivariate analysis carried out the influence of dosage on pain relief, at each time point. The Jadad scale was used to assess risks of bias and GRADE for certainty of evidence. RESULTS: Eleven studies were included in the meta-analyses (n = 1125 patients). Low dose was significantly superior to normal saline in the VST, but not in the ST (low-quality evidence). No data were available for the MT. The usual dose was significantly superior to normal saline in the ST, but not in the VST and MT (moderate-quality evidence). A high dose was significantly superior to normal saline in the ST and MT (low-quality evidence). Multivariate analysis showed that the dose significantly influenced pain reduction at ST and MT, but not in the VST (low-quality evidence). CONCLUSION: The dose of IACI doesn't influence pain reduction in the peak effect, but a higher dose seems to have a more prolonged effect.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.032 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.040 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".