More than 50% of patients with anterior cruciate ligament (ACL) rupture develop radiographic abnormalities and post-traumatic osteoarthritis within five to 15 years post-injury. This study was designed to determine whether steroid injections affect the inflammatory biomarkers evident in the joint after such injuries.

Patients with ACL tears received intra-articular injections at four days and two weeks post-injury. Group one received a corticosteroid injection (triamcinolone, 40 mg) at four days and a placebo at two weeks. Group two received a placebo saline injection at four days and a corticosteroid injection at two weeks. Group 3 received corticosteroid injections at both time intervals. Group four received placebo injections at both intervals.

Arthrocentesis was performed on the day of initial presentation, between six and 10 days after the initial visit and on the day of surgery. Patient-reported outcomes were collected at the initial visit and at the time of surgery, with outcome scores obtained from the 5 KOOS subscales, the International Knee Documentation Committee Measure, visual analog scale pain scale and the Pain Catastrophizing Scale. Both chondrodegenerative and inflammatory markers worsened over the first five weeks, while all patient-reported outcomes improved during this time. Patient-reported outcomes did not differ between those of patients in the corticosteroid group and those in the placebo group. Increases in CTX-II, associated with greater type II collagen breakdown, were significantly greater in the placebo group than either of the two groups receiving steroids within the first several days post-injury.

This study of patients with ACL ruptures found that biochemical indicators of early osteoarthritis were evident before surgery, with intra-articular steroids able to suppress some of these.