Intra-articular treatments in osteoarthritis: from the symptomatic to the structure modifying

The symptomatic and structural efficacy of intra-articular (IA) injections is reviewed. IA corticosteroid injections are rapidly effective, but their symptomatic benefit is short lived. Hyaluronan has delayed onset of efficacy but its benefit for pain may be longer lasting. Lavage and debridement are probably not as efficacious as once thought in osteoarthritis.