title: Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain Sensitivity in Knee Osteoarthritis: Exploratory Outcome from a Randomized Controlled Trial.
abstract: OBJECTIVE
  To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA).
  
  
  METHODS
  Randomized, masked, parallel, placebo-controlled trial involving 100 participants with clinical and radiographic knee OA that were randomized to one intra-articular injection on the knee with either 1 ml of 40 mg/ml methylprednisolone (corticosteroid) dissolved in 4 ml lidocaine (10 mg/ml) or 1 ml isotonic saline (placebo) mixed with 4 ml lidocaine (10 mg/ml). Two weeks after the injections all participants undertook a 12-week supervised exercise program. Main outcomes were changes from baseline in pressure-pain sensitivity (pressure-pain threshold [PPT] and temporal summation [TS]) assessed using cuff pressure algometry on the calf. These were exploratory outcomes from a randomized controlled trial.
  
  
  RESULTS
  A total of 100 patients were randomized to receive either corticosteroid (n = 50) or placebo (n = 50); 45 and 44, respectively, completed the trial. Four participants had missing values for PPT and one for TS at baseline; thus modified intention-to-treat populations were analyzed. The mean group difference in changes from baseline at week 14 was 0.6 kPa (95% CI: -1.7 to 2.8; P = 0.626) for PPT and 384 mm×sec (95% CI: -2980 to 3750; P = 0.821) for TS.
  
  
  CONCLUSIONS
  These results suggest that adding intra-articular corticosteroid injection 2 weeks prior to an exercise program does not provide additional benefits compared to placebo in reducing pain sensitivity in patients with knee OA.
  
  
  BACKGROUND
  EU clinical trials (EudraCT): 2012-002607-18.
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Soriano-Maldonado
authors.affiliation: The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Louise
authors.initials: L
authors.lastname: Klokker
authors.affiliation: The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.|Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Bartholdy
authors.affiliation: The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bandak
authors.affiliation: The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Karen
authors.initials: K
authors.lastname: Ellegaard
authors.affiliation: The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Bliddal
authors.affiliation: The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.|Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Marius
authors.initials: M
authors.lastname: Henriksen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000187:drug effects* / Q000473:pathology; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000473:pathology / Q000628:therapy*; D010146:Pain / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D017288:Pain Threshold / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local; D008012:Lidocaine; D008775:Methylprednisolone