Intraarticular corticosteroid injections in the management of osteoarthritis knee
Objective:- The aim of the study was to assess therapeutic efficacy, adverse events and patient satisfaction of intraarticular (IA) corticosteroid injections for knee osteoarthritis (OA).
Methods:- Ninety-Six (96) patients with OA of the knee participated in the present study. The inclusion criteria included (1) Resting visual analog scale pain >50 mm (2) Radiographic evidence for osteoarthritis (as per Kellgren-Lawrence scale) plus; age ≥50yrs, morning stiffness ≤ 30 min and crepitus on the motion. Baseline Western Ontario and MacMaster University Osteoarthritis Index (WOMAC) and visual analogue score (VAS) were documented. Patients received intra-articular injections of triamcinolone acetonide 40 mg in the affected knee. The patients were reviewed at 1 week, 4 weeks and 8 weeks post-injection with final analysis at 3 months. Use of over the counter analgesia in the form of acetaminophen was allowed for concomitant analgesia.
Results:- Ninety-six patients (male =45, female=51) with mean age of 50±5 years (range 45-55); duration of symptoms 5.7 ± 0.5 years and mean body mass index (BMI) 29.4kg/m2 were available at final follow-up. The VAS scores at baseline were:- at rest=71 and after 30 meter walk=80 and improved to 35 and 40, respectively. Improvement in pain and disability based on the WOMAC scores were significant. The overall efficacy “Knee Society Score” was judged as excellent in 56.25%, satisfactory in 21.87%, fair in 18.75%, and poor in 3.12%. The beneficial effects stayed until 4-6 weeks.
Conclusion:- Intra-articular steroid injections for knee OA is safe and effective. The symptomatic relief is prompt, particularly in the presence of inflammation (Effusion/synovitis). Proper patient selection and aseptic precautions yield satisfactory results. The need for concomitant analgesia is reduced.
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