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Articular Cartilage Deterioration Not Due To Aging

By the time the first changes of radiological osteoarthritis are detected, 13% of knee cartilage has already been lost.⁷⁶ Articular cartilage volume normally decreases by two to three percent per year.⁷⁷ Researchers have already shown that lifelong moderate use of normal joints does not increase the risk of OA.^78-80 The degeneration of normal articular cartilage is not simply the result of aging and mechanical wear. Once OA forms, articular cartilage volume decreases at a rate of about four to five percent per year.^81-83 The rate of loss at two years predicts subsequent total knee arthroplasty. For every one percent increase in the rate of tibial cartilage loss there was a 20% increase risk for undergoing a knee replacement at four years.⁸⁴ Surely we all should be asking the question what is causing this increase in tibial (joint) cartilage loss beyond that occurring with the normal aging process? Could it be the actual anti-inflammatory medications used by doctors to treat osteoarthritis?

While it is easier to microscopically study the effects of intraarticular corticosteroids in animals and compare them to non-injected joints because animals can be sacrificed, the same is not so in humans. For this reason, less human data exists, but what is available is compelling. Intrarticular corticosteroids accelerate human articular cartilage deterioration just like in animals.