Long-term joint damage could be avoided with Glucocorticoid Treatment

Late life osteoarthritis (OA) could be an eventual fall out of a joint injury that causes irreversible cartilage damage despite treatment and surgery. In a new study published in the journal Arthritis Research & Therapy, researchers demonstrate that OA could be possibly prevented after injury, and long term degenerative changes could be avoided by short term treatment of the damaged cartilage with glucocorticoids.

A normal joint cap comprises a cartilage layer containing proteoglycans such as aggrecan in addition to lubricating fluid containing glycosaminoglycans (GAG) such as hyaluronic acid. Subsequent to an injury, proteoglycans and other cartilage molecules break down, which decreases proteoglycan synthesis within the cartilage. Cartilage GAG loss is further enhanced due to the release of proinflammatory cytokines such as TNFα, IL-1β, and IL-6 into the synovial fluid, following injury.
Glucocorticoid dexamethasone (DEX) demonstrated decreased GAG losses and restored proteoglycan synthesis levels to normal, in a “worst-case scenario” situation involving mechanical injury to the cartilage followed by an attack of immune system-stimulating bio-molecules, TNFα and IL-6.

“Glucocorticoid injections are sometimes used to relieve the pain of established osteoarthritis, but there are concerns about long-term use. Our results suggest that short-term glucocorticoid treatment after joint injury may help restore components of cartilage to preinjury levels and consequently may prevent the long term changes which lead to osteoarthritis,” said Prof Alan Grodzinsky from the MIT Center for Biomedical Engineering.