http://austinpublishinggroup.com/orthopedics-rheumatology/
Background:
Osteoarthritis is a chronic
degenerative disorder of multifactorial etiology characterized by the loss of
articular cartilage, resulting in joint pain, stiffness, swelling, and
disability without any clear answer to its treatment and cure. Studies from intra-articular
steroid with local anesthetic uses in osteoarthritis are rare from India.
Objective:
To determine the effectiveness and
safety of administering a combination of intra-articular corticosteroid and
local anesthetic in Indian patients with knee osteoarthritis.
Methods:
This, prospective, open-label,
observational single-center pilot study was conducted at the Rheumatology
Clinic of a tertiary care centre, from December 2015 to December 2016. This,
prospective, open-label, observational single-center pilot study included
patients (n=20) between 35-70 years of age, suffering from chronic knee pain
for at least three months prior to inclusion, with a clinical or radiological
diagnosis of knee osteoarthritis, dissatisfied with previous non-surgical management.
Patients were administered injection methylprednisolone 80 mg (2 ml) plus
lignocaine 1% (0.5 ml) intra-articularly which were followed with five
scheduled visits i.e. baseline (visit 1), day 1 (visit 2), 6 weeks (visit 3),
12 weeks (visit 4), and 24 weeks (visit 5). Patients were evaluated on a Visual
Analogue Scale [VAS] for pain and patient reported self-assessment
questionnaire to evaluate other clinical effectiveness parameters.
Results:
Mean age of the study population
was 52.55+7.91 years. Majority (85%) were females. After administration of the
injection, pain (as measured by the VAS scale) improved within a day and there
was complete (100%) pain relief in all patients (as per subjective assessment)
at week 1. The VAS score reduced from 8.90+0.968 at baseline to 6.35+1.387 on
day 1 (mean reduction of 2.55+1.191) and 5.30+0.923 at week 1 (mean reduction
of -3.60+1.273). For each of the clinical effectiveness parameters, a
significantly greater proportion of patients showed ‘improved’ status than
those who ‘worsened’ or remained the same. Seventy percent (14/20) patients
reported ‘decreased’ frequency of Non- Steroidal Anti-Inflammatory Drug (NSAID)
usage (p=0.0368).
Conclusion:
Combination injection of
intra-articular corticosteroid and local anesthetic is safe and effective in
Indian patients with osteoarthritis. It achieves immediate pain relief, with
effects lasting for at least 6 months and helps decrease NSAID usage in most
patients.
Keywords: Osteoarthritis;
Injections; Intra-articular; Anesthetics; Local; Visual Analog Scale;
Anti-inflammatory agents; Non-steroidal
