Question 2. What is the evidence suggesting that corticosteroids are detrimental to normal joint health?
Twenty-one articles were included to answer question 2. These were 10 pre-clinical in vivo studies (Saari et al., 1992; Frisbie et al., 1997; Frisbie et al., 1998; Murray et al., 1998; Hills, Ethell & Hodgson, 1998; Todhunter et al., 1998; Robion et al., 2001; Céleste et al., 2005; Knych et al., 2017; Knych et al., 2018) and 11 in vitro investigations (Murphy et al., 2000; Fubini et al., 2001; Frean, Cambridge & Lees, 2002; Tung, Venta & Caron, 2002; Tung et al., 2002; Richardson & Dodge, 2003; Doyle et al., 2005; Byron et al., 2008; Busschers, Holt & Richardson, 2010; Palma et al., 2019a; Palma et al., 2019b). Risk of bias was rated for all in vivo studies, which were mainly considered as “unclear risk,” with two rated as “high risk” (Figure 3). Summaries are available in Supplementary Material 2.