title: Intra-Articular Injections in Patients with Femoroacetabular Impingement: a Prospective, Randomized, Double-blind, Cross-over Study.
abstract: We evaluated and compared the effectiveness of intra-articular injection of hip joint using hyaluronic acid and steroid in patients with femoroacetabular impingement (FAI). Thirty patients with FAI clinically and radiologically were enrolled and underwent hip injection using steroid (TA) or hyaluronic acid (HA) at 0-weeks with cross-over injection at 2-weeks in patients without clinical response of decrease of pain intensity less than 2-point. Patients were followed up to 12-weeks for pain intensity (Numeric rating scale, NRS: 0-10), hip disability score (HOOS), oral medication and adverse events. In 17 patients without cross-over, HOOS at 2-weeks was improved significantly in patients with HA injection (mean increase of HOOS = 13.8 with HA vs. -2.2 with TA, P = 0.031) without difference of NRS (P = 0.943). In 13 patients with cross-over, NRS was significantly improved at 2-weeks with first TA injection (mean decrease of NRS= 1.7 with first TA vs. 0.3 with first HA, P = 0.036), without difference of HOOS (P = 0.431). At 4-weeks, NRS and HOOS were significantly different according to injection drugs (NRS: 0.9 with TA first and HA later vs. 2.7 with HA first and TA later, P = 0.001; mean increase of HOOS: 5.3 with TA first and HA later vs. 10.2 with HA first and TA later, P = 0.032). Intra-articular hip injection may be effective in FAI, with faster effect of pain improvement by TA and more delayed effect of function improvement by HA.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young Kyun
authors.identifier: http://orcid.org/0000-0001-6564-4294
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Radiology, Chung-Ang University Hospital, Seoul, Korea. netty0523@gmail.com.
authors.forename: Guen Young
authors.identifier: http://orcid.org/0000-0002-6906-5182
authors.initials: GY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Joon Woo
authors.identifier: http://orcid.org/0000-0002-7106-5229
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eugene
authors.identifier: http://orcid.org/0000-0003-4205-2362
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Heung Sik
authors.identifier: http://orcid.org/0000-0002-7024-388X
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D057925:Femoracetabular Impingement / Q000188:drug therapy*; D005483:Flushing / Q000209:etiology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D013256:Steroids / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013256:Steroids; D006820:Hyaluronic Acid
keywords: Femoroacetabular Impingement; Glucocorticoids; Hip; Hyaluronic Acid; Injections