Intra-articular corticosteroids are primarily used for pain secondary to osteoarthritis but they can also be used in inflammatory conditions such as rheumatoid arthritis. They do not slow down or change the progression of arthritis.
They are generally used in patients with arthritic symptoms who are not symptomatic enough to warrant a total joint replacement. It is also used when trying to delay an inevitable joint replacement.
They are also useful in patients who are not medically fit for surgery.
Arthrocentesis – Also called joint fluid aspiration, arthrocentesis is removal of joint fluid through a hollow needle inserted into the joint space of the knee. Although the purpose of removing joint fluid from the knee is usually so that it can be tested in the lab, removing excess fluid can also quickly ease pain and swelling. Often after withdrawing fluid, doctors use the same puncture site where the fluid was removed to inject a corticosteroid preparation and/or anesthetic into the knee joint to further relieve pain and inflammation.
Numerous trials (CATT trial, IVAN trial, GEFAL, MANTA, LUCAS) conducted worldwide have shown Bevacizumab injection in the eye to be non-inferior to Ranibizumab injection in the eye in terms of efficacy and safety in AMD. Bevacizumab on the other hand has the advantage of significantly reducing the cost of therapy. However, intravitreal bavacizumab injection has not been approved by the Food and Drug Administration (FDA) and the use in the eye is hence 'off label'. All patients need to be clearly informed when taking written consent for intraocular bevacizumab.