A randomized, prospective, double-blind study to investigate the effectiveness of adding DepoMedrol to a local anesthetic injection in postmeniscectomy patients with osteoarthritis of the knee.
BACKGROUND
Patients with osteoarthritis of the knee are at risk for poorer outcomes after arthroscopic meniscectomy. Intra-articular corticosteroid injections have been shown to be efficacious both in patients with osteoarthritis and postarthroscopy patients.


OBJECTIVE
A postoperative, intra-articular methylprednisolone and lidocaine injection in patients with chondromalacia undergoing meniscectomy will improve patient-rated pain and function compared with control patients.


METHODS
Randomized, controlled trial; Level of evidence, 1.


METHODS
A total of 58 patients (59 knees) were randomized in a double-blinded fashion to receive either saline plus lidocaine (saline) or methylprednisolone plus lidocaine (steroid) after arthroscopic meniscectomy in which chondromalacia (modified Outerbridge grade 2 or higher) was confirmed. Preoperatively and at follow-up-6 weeks and 6, 9, and 12 months-patients underwent an examination and completed a subjective functioning survey. Scores were calculated using several validated scoring systems including the Lysholm, International Knee Documentation Committee (IKDC), and Short Form-12 (SF-12).


RESULTS
No statistically significant differences were observed between the saline (n = 30) and steroid (n = 29) groups in their demographics and preoperative scores. At 6 weeks, the steroid group had higher scores than the saline group on multiple scales, including the IKDC. No differences in outcome scores existed at later time points. At 12 months, 86% of the steroid and 69% of the saline group were completely or mostly satisfied with the procedure (P = .01). In the saline group, 4 patients required reinjection and 2 underwent joint replacements within 12 months, while the steroid group had 3 reinjections and 2 meniscus transplants.


CONCLUSIONS
The addition of a postoperative corticosteroid injection resulted in improved pain and function at an early time point; however, it provided no lasting difference compared with only local anesthetic injection.
Koyonos
Loukas
L
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
Yanke
Adam B
AB
McNickle
Allison G
AG
Kirk
Spencer S
SS
Kang
Richard W
RW
Lewis
Paul B
PB
Cole
Brian J
BJ
D000328:Adult; D000368:Aged; D000777:Anesthetics; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001182:Arthroscopy; D046789:Chondromalacia Patellae; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D011182:Postoperative Care; D011446:Prospective Studies; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome; D055815:Young Adult
D000777:Anesthetics; D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D008012:Lidocaine; D008775:Methylprednisolone