title: 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.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
authors.forename: Loukas
authors.initials: L
authors.lastname: Koyonos
authors.forename: Adam B
authors.initials: AB
authors.lastname: Yanke
authors.forename: Allison G
authors.initials: AG
authors.lastname: McNickle
authors.forename: Spencer S
authors.initials: SS
authors.lastname: Kirk
authors.forename: Richard W
authors.initials: RW
authors.lastname: Kang
authors.forename: Paul B
authors.initials: PB
authors.lastname: Lewis
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
mesh_terms: 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
chemical_list: D000777:Anesthetics; D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D008012:Lidocaine; D008775:Methylprednisolone