Intra-articularcorticosteroids are often used along with local anesthetics to treat
osteoarthritis probably due to the rationale that the local anesthetic
component acts quickly after administration, to provide immediate pain relief,
and its action may last until the corticosteroid component starts to exert its
effect. While some studies suggest that a combination local
anesthetic/corticosteroid may have potential negative effects on
intra-articular cell viability and cell metabolism, and may lead to chondrotoxicity,
others support continued safe use of this combination in clinical practice.
Nonetheless the combination of intra-articular steroids and local anesthetics
is routinely administered universally (either in the same syringe or
separately) to treat osteoarthritis.
The potential advantage of rapid onset
and prolonged duration of action offered (which enables instant pain relief and
anti-inflammatory response) by combination of intra-articular steroids and
local anesthetics, as well as the controversy surrounding its safety makes it
imperative to examine its effectiveness and safety in patients with knee
osteoarthritis. However, studies exploring the effectiveness and safety of this
combination are limited especially in
India. Therefore, this pilot study was conducted to determine the effectiveness
and safety of administering a combination of intra-articular corticosteroid and
local anesthetic in Indian patients with knee osteoarthritis.
Adults between 35-70 years of age,
suffering from chronic knee pain (pain score at least 3 cm on Visual Analogue
Scale [VAS] for at least three months prior to inclusion, with a clinical or
radiological diagnosis of knee osteoarthritis, dissatisfied with previous
non-surgical management including analgesics and other drugs were included
after informed consent. Those with severe, advanced, destructive arthritis with
deformity, neuropathic or septic arthritis.
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