A Year in Review - 2023

Injectable medications for osteoarthritis questioned

Our researchers at the Kolling Institute encouraged people with osteoarthritis to rely on treatments with a proven track record and to avoid quick fixes without the data to show they work.

The comments follow a steady rise in osteoarthritis cases nationally, with around three million Australians now living with the condition, and many forced to retire early. The rise in cases coincided with a strong interest in injectable medications, particularly for knee osteoarthritis, such as hyaluronic acid, stem cells, and platelet-rich plasma. But Royal North Shore Hospital rheumatologist and world-leading osteoarthritis researcher Professor David Hunter said there was not the data to show these injections work.

“Individuals with osteoarthritis need to be encouraged to manage their condition using behaviour and lifestyle interventions in the knowledge that the development of disease-modifying drugs might still be some way away,” he said. “Some of the evidence-based treatments include doing exercises that strengthen the muscles around the affected joint. “We recommend working with a physiotherapist or an exercise physiologist trainer to learn how to strengthen those muscles.” David said staying active and losing weight, if you carry extra kilos, were also important steps that could make a difference. “We know that losing five per cent of body weight can improve joint pain and function by 30 per cent. This can have a significant impact.” Research indicates cortisone injections could be used for short-term relief but not a long- term solution. “One injection may be fine but repeat steroid injections appear to increase the risk of progressing the disease,” he said. More information on treatments and the latest advice can be found on websites including Arthritis Australia, My Joint Pain and Joint Action.

“The hyaluronic acid injections are no better than a saltwater injection, but they will cost you a lot more, while we just don’t have good enough evidence for the stem cell injections or the platelet-rich plasma,” said the University of Sydney researcher. David was disappointed that the latest evidence on treatments was not filtering through to consumers and new resources were not reaching those with osteoarthritis. He would like to see a stronger focus on the core treatments which work.

Professor David Hunter

44 NSLHD 2023 Year in Review

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