title: Ultrasound guided intra-articular ketorolac versus corticosteroid injection in osteoarthritis of the hip: a retrospective comparative study.
abstract: OBJECTIVE
  Intra-articular steroid injection has been widely used in the management of symptomatic osteoarthritis; however, its frequent use is avoided since there is an increase in the incidence of articular infection and several mechanical side effects such as cartilage breakdown and loss of elasticity of the articular cartilage. For these reasons, nonsteroidal anti-inflammatory drugs instead of corticosteroids can be considered for intra-articular injection. On this basis, we investigated the effects and safety of ultrasound-guided intra-articular ketorolac versus corticosteroid injection for patients with osteoarthritis of the hip.
  
  
  METHODS
  This retrospective study included 98 patients with diagnoses of hip osteoarthritis who underwent ultrasound-guided intra-articular ketorolac or corticosteroid injection. Fifty patients who received ultrasound-guided intra-articular corticosteroid injection were administered a mixture of 0.5% lidocaine and triamcinolone. Forty-eight patients who received ultrasound-guided intra-articular ketorolac injection were administered 0.5% lidocaine and ketorolac. Outcome measurement was assessed using the Harris hip score and verbal numeric pain scale, which were evaluated before the injections and at 1, 3 and 6 months following the injection. Univariate analysis (using the x (2) test) and multiple logistic regression analysis were performed to evaluate the relationship between the possible outcome predictors (injected medications, patients' age, gender, pain duration and Kellgren-Lawrence classification) and the therapeutic effects.
  
  
  RESULTS
  The Harris hip score and verbal numeric pain scale were improved at 1, 3 and 6 months after the injection in both groups. No statistical differences in the Harris hip score and verbal numeric pain scale were observed between the groups. The success rate was also not significantly different among the time periods of 1, 3 and 6 months. Multiple logistic regression and univariate analysis showed that injected medications patients' age, gender, pain duration and Kellgren-Lawrence classification were not independent predictors of successful outcome at midterm follow-up.
  
  
  CONCLUSIONS
  The treatment of osteoarthritis of the hip with intra-articular ketorolac injection is as effective as that with intra-articular corticosteroid injection. Intra-articular ketorolac injection can be considered useful for patients with contraindications to using corticosteroids.
authors.affiliation: Department of Rehabilitation Medicine, Gachon University, Gil Medical Center, Incheon, South Korea.
authors.forename: Ki Deok
authors.initials: KD
authors.lastname: Park
authors.forename: Tai Kon
authors.initials: TK
authors.lastname: Kim
authors.forename: Byung Woo
authors.initials: BW
authors.lastname: Bae
authors.forename: JaeKi
authors.initials: J
authors.lastname: Ahn
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Lee
authors.forename: Yongbum
authors.initials: Y
authors.lastname: Park
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D018771:Arthralgia / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D020910:Ketorolac / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D010147:Pain Measurement / Q000187:drug effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac