Intraarticular Corticosteroids for Hip Osteoarthritis: A Review

Choueiri, Magda; Chevalier, Xavier; Eymard, Florent

doi:10.1177/1947603520951634

Cited by 23 publications

(17 citation statements)

References 60 publications

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“…This research was designed to investigate the actual potential value of PENG block on outcome measures including pain and function in hip OA, compared to IAI. According to many studies, IAI provide a therapeutic window of up to 8-12 weeks; therefore, a follow-up period of 8 weeks was chosen [8]. The present findings suggest that the ultrasound-guided PENG block is an effective treatment approach in patients with OA; the effect was greatest at day 1, and clinically significant relief of hip pain was sustained for 2 months.…”

Section: Discussionmentioning

confidence: 58%

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Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

Köse

Köse²,

Çelikel

et al. 2023

Korean J Pain

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Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen's d = 4.62), and IAI group at 4 (Cohen's d = 5.15) and 8 (Cohen's d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen's d = 2.16, P = 0.007) and WOMAC (Cohen's d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.

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Section: Discussionmentioning

confidence: 58%

“…Intra-articular injection (IAI) of corticosteroids, as a mainstay of non-operative treatment, has been a frequently performed procedure over the past several decades [8]. The American College of Rheumatology (ACR) and the American Association of Orthopedic Surgeons recommended IAI for the treatment of hip OA [9,10].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

Köse

Köse²,

Çelikel

et al. 2023

Korean J Pain

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“…Usually, the effect of injection reduces joint pain successfully up to three weeks post injection, while diminishing after longer periods [72]. However, there is no assumption to confirm their effect in improving of joint function.…”

Section: Injectable Treatmentmentioning

confidence: 99%

Pathophysiology of osteoarthritis and Current Treatment

Ali

2021

Zagazig Veterinary Journal

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Osteoarthritis (OA) is considered the prevalent arthritis in human and some animals, causing joint pain and disability that reduces quality of life. The exact etiology of OA is unknown till now but there is a variety of predisposing factors for the occurrence of osteoarthritis (OA) such as previous joint injury, genetics, obesity, sex, anatomical abnormalities and excessive load; meanwhile, the predominant factor is ageing. Understanding the pathophysiology of osteoarthritis is a must to provide effective treatment options. Previous researches had studied the pathophysiology of osteoarthritis However several controversies still present. Currently still there is no substantial therapy for OA; treatment options concentrate on the relief of signs. The main goals of therapy are pain relief, improved joint function, and joint stability. New trials of therapies are under study and some of them did promising effects as approaches to regenerative medical therapies such as Platelet Rich Plasma (PRP) and Nanotechnology. The purpose of this study is to provide an overview of pathophysiology information and of the various therapeutic resources suitable for OA.

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“…Intra-articular hip CSI in the setting of hip osteoarthritis has been studied fairly extensively. [20][21][22] It is widely accepted that hip CSI may offer short-term symptomatic relief in hip pain lasting up to 12 weeks with studies showing that patients with more severe osteoarthritis and higher baseline pain see more significant benefit. [20][21][22][23] However, the utility of corticosteroids in a non-arthritic hip joint has not received significant attention.…”

Section: Introductionmentioning

confidence: 99%

Intra-articular corticosteroids associated with increased risk of total hip arthroplasty at 5 years

et al. 2022

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Background: Intra-articular corticosteroid injections are commonly administered for hip pain. However, guidelines are conflicting on their efficacy, particularly in patients without arthritis. This study assessed for an association of corticosteroid injections and the incidence of total hip arthroplasty at 5 years. Methods: Patients with a diagnosis of hip pain without femoroacetabular osteoarthritis who were administered an intra-articular corticosteroid injection of the hip within a 2-year period were identified from the Mariner PearlDiver database. Patient were matched to patients with a diagnosis of hip pain who did not receive an injection. 5-year incidence of total hip arthroplasty was compared between matched patients who received an intra-articular corticosteroid injection and those who did not. Results: 2,540,154 patients diagnosed with hip pain without femoroacetabular arthritis were identified. 25,073 (0.9%) patients received a corticosteroid injection and were matched to an equal number of control patients. The incidence of total hip arthroplasty (THA) at 5-year-follow up was significantly higher for the corticosteroid cohort compared to controls (1.1% vs. 0.5%; p < 0.001). The incidence and risk of THA increased along with number of injections (1 injection: 0.8%, OR 1.37; 95% CI, 1.34–1.42; p < 0.001, 2 injections: 1.1%; OR 1.45; CI, 1.40–1.50; p < 0.001, ⩾3 injections: 1.5%; OR 1.48; CI, 1.40–1.56; p < 0.001). Conclusions: There may be a dose-dependent association of corticosteroid injections and a greater risk of total hip arthroplasty at 5 years. These results along with the conflicting guidelines on the efficacy of intra-articular steroids for hip pain should prompt physicians to consider osteoarthritis progression that may occur in the setting of corticosteroid injections in non-arthritic hips.

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Intraarticular Corticosteroids for Hip Osteoarthritis: A Review

Cited by 23 publications

References 60 publications

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

Pathophysiology of osteoarthritis and Current Treatment

Intra-articular corticosteroids associated with increased risk of total hip arthroplasty at 5 years

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