Intra-Articular Injections in Knee Osteoarthritis: A Review of Literature (original) (raw)
Related papers
Asian Journal of Pharmaceutical and Clinical Research, 2022
Objective: The objective of the study was to assess the safety and efficacy of intra-articular steroid injections in osteoarthritis of knee. Methods: This prospective observational study was conducted for a period of 12 months in a tertiary care hospital. Patients were given intra-articular injections of triamcinolone hexacetonide 40 mg (1 cc) in the affected knee at the time of enrollment and thereafter at 6 and 12 weeks. The treatment response was evaluated based on the improvement in the various clinical scoring systems. Comparison of quantitative variables of successive followup with baseline value was analyzed. p < 0.05 was taken as level of significance. Results: Of the 106 patients included in the study, the mean age was 64.12±8.69 years. The mean 50 foot walking time improved from 13.85 s to 12.64 s (p=0.003) by 24 weeks. Range of motion improved from a mean of 126.75-131.63° (p=0.001). The physician's global assessment score improved from a baseline mean of 54.42-46.39 while the patient's global assessment score progressed from 57.8 to 46.38 both being statistically significant. Patient's pain assessment score reduced from baseline mean value of 57.32-45.95 and nocturnal pain improved to 30.24 at 24 weeks from a baseline value of 36.51. The mean Western Ontario and McMaster Universities Osteoarthritis Index score improved to 45.93 from baseline of 56.92. Conclusion: Repetitive IA steroid injections appear to be safe with no significant deleterious effects on the anatomical joint structure.
Effect of intraarticular steroid injection in addition to physical modalities in osteoarthritis knee
Journal of Dhaka Medical College, 2015
Context: Osteoarthritis (OA) is the most common form of arthritis accounting for about 30% of general physician visits. Intrarticular (IA) corticosteroid injections have been used for decades in clinical practice for pain relief and control of local inflammation in OA. In the present study a combined therapy of long acting intra-articular injection in addition to physical modalities of OA knee was given to find out the functional improvement and clinical outcome of the patient. Methods: It was a prospective interventional non-randomized clinical study conducted in the Department of Physical Medicine & Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from October, 2011 to March, 2012. Fifty four patients between 35 and 75 years without consideration of gender with a history of not less than three months knee pain with radiographic confirmation of primary osteoarthritis were selected purposefully. Then they were divided randomly in group A and B, having 27 p...
Pakistan Journal of Medical and Health Sciences, 2022
Objectives: To compare the frequency of disease progression in patients with osteoarthritis of knee treated with versus without intra-articular injection of corticosteroids. Design: The present study was a randomized single-blind controlled trial. Study Settings: The current study was conducted at Department of Orthopedic Surgery at Sir Ganga Ram Hospital Lahore over 1 year from May 2020 to April 2021. Study Procedure: The present study was conducted over 186 patients of both genders aged between 40-70 years presenting in outpatient department of orthopedic surgery with osteoarthritis of knee joint. The sampled patients were randomly allotted into two treatment arms. Patients from Group-A received intraarticular injection of steroids in addition to conservative management while those in Group-B were taken as controls and were managed conservatively without intraarticular injection of steroids. Outcome variable was frequency of disease progression over KL grading which was noted and compared between the groups. An informed on paper consent was obtained from every participant. Results: The mean age of the patients was 52.5±8.7 years. There was a female predominance with a male to female ratio of 1:1.7. The mean BMI of these patients was 28.3±3.6 Kg/m 2 and 60 (32.3%) patients were obese. 103 (55.4%) patients had grade 2 while 83 (44.6%) patients had grade 3 osteoarthritis. Disease progression was noted in 30 (16.1%) patients after 6 months follow-up. The frequency of disease progression was significantly higher in patients receiving intra-articular injection of corticosteroids as compared to controls (26.9% vs. 5.4%; p-value<0.001). When stratified, comparable difference was observed across various subgroups of patients based on patient's age, gender, BMI and baseline Kellgren-Lawrence Grade. Conclusion: In the present study intraarticular injection of steroids was found to be associated with articular cartilage damage evident from increased frequency of disease progression following intraarticular injection as compared to controls which advocates that intraarticular injection of steroids should be avoided in the management of osteoarthritis and should be reserved only for patients with advanced disease and who are already planned for joint replacement.
A Comparative Study in Injectable Knee Osteoarthritis Interventions
Further research can now be done in comparing injection therapies with OA in different joints, as adjunctive treatment in surgery or in comparison to such surgeries. Research that focuses of imaging techniques like ultrasound and MRI along with histology can be used to better demonstrate the mechanisms of action.
Drugs in R and D, 2011
Osteoarthritis (OA), also called degenerative joint disease, is the most frequently occurring chronic musculoskeletal disease, particularly affecting the aging population. The use of viscosupplementation, i.e. intra-articular (IA) hyaluronic acid (HA) drug therapy, to treat OA, is growing worldwide, due to important results obtained from several clinical trials, which reported IA HA-related improvements in functional activity and pain management. This review is an update of the IA use of this compound in the treatment of OA, with clinical evidence from the last few years being discussed and used to delineate new trends for the future.
Orthopedics and Rheumatology Open Access Journal, 2017
Background: Osteoarthritis is one of the most common degenerative disorders of cartilage in old age the treatment and prevention of which poses a tremendous challenge. The aim of this study was to compare the effects of hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis. Materials and Methods: In this clinical trial, 34patients with knee osteoarthritis were enrolled. Patients were randomly divided into two groups. In this study hyaluronic acid was administrated at a dose of 20mg per 2ml (3 infusions every 2 weeks) and triamcinolone acetate was administrated at a dose of 40mg per 1cc and 1cc of lidocaine (1injection). Pain, joint stiffness, movement restriction and grad of osteoarthritis were compared in the two groups. Results: The results showed that hyaluronic acid relieved movement restriction (41.58 to 28.35) (PV = 0.001) and corticosteroids reduced pain (14.52 to 12.52) (PV = 0/011) in patients Conclusion: The results suggested the effect of hyaluronic acid on reducing restriction of movement and corticosteroids on pain relief in patients.
The Journal of Rheumatology, 2018
Objective.We examined the longterm effectiveness of corticosteroid or hyaluronic acid injections in relieving symptoms among persons with knee osteoarthritis (OA).Methods.Using Osteoarthritis Initiative data, a new-user design was applied to identify participants initiating corticosteroid or hyaluronic acid injections (n = 412). Knee symptoms (pain, stiffness, function) were measured using The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). We used marginal structural models adjusting for time-varying confounders to estimate the effect on symptoms of newly initiated injection use compared to nonusers over 2 years of followup.Results.Among 412 participants initiating injections, 77.2% used corticosteroid injections and 22.8% used hyaluronic acid injections. About 18.9% had additional injection use after initiation, but switching between injection types was common. Compared to nonusers, on average, participants initiating a corticosteroid injection experienced ...