Intraarticular corticosteroid injection: pain relief in osteoarthritis of the hip?
OBJECTIVE
Osteoarthritis (OA) is one of the most common causes of morbidity in the elderly population, and surgery is often preceded by years of pain and disability. Intraarticular corticosteroid injections in osteoarthritic joints may play a role in the therapeutic plan and can afford quick pain relief but do not alter the underlying disease. There is a paucity of well controlled studies that provide recommendations for the use of corticosteroids in OA of the hip.


METHODS
A prospective analysis of 80 patients with OA of the hip and pain at rest and on bearing weight for more than 4 weeks was performed. Patients were randomized into 2 groups; group 1 (n = 40) received corticosteroid (80 mg triamcinolone acetonide) and group 2 (n = 40) local anesthetic (1% mepivacaine), injected into the hip joint under fluoroscopy. Pain, functional ability, range of motion of the joint, and analgesics consumed were registered 3 weeks postinjection. The treatment was blind for the patients and the investigators performing the followup.


RESULTS
Pain for all modalities decreased after corticosteroid injection, but pain at rest decreased the most. There was significant pain reduction at the 3 (and 12) week followup. Joint range of motion increased significantly for all directions. Functional ability improved significantly after injection. We found no significant pain relief or improvement of functional ability in patients treated with local anesthetics.


CONCLUSIONS
This study suggests that intraarticular corticosteroids might improve pain and range of motion of the affected joint in patients with hip OA.
Kullenberg
Björn
B
Department of Orthopedics, Blekinge Hospital, Karlshamn, Sweden. bjorn.kullenberg@lthlekinge.se
Runesson
Ronny
R
Tuvhag
Richard
R
Olsson
Christer
C
Resch
Sylvia
S
D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007270:Injections, Intra-Articular; D008619:Mepivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D015207:Osteoarthritis, Hip / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000187:drug effects; D012146:Rest; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*
D000779:Anesthetics, Local; D005938:Glucocorticoids; D008619:Mepivacaine; D014222:Triamcinolone Acetonide