Predictors of response to intra-articular steroid injections in patients with osteoarthritis of the knee joint

Abstract

This study aimed to determine the factors associated with response to intra-articular steroid injection (IASI) in patients with knee joint osteoarthritis. One hundred seventy-four female patients, age ranging from 30 to 80 years, diagnosed to have osteoarthritis of the knee joint, were given IASI. Response to IASI was assessed by using WOMAC and VAS at 2 weeks, 4 weeks and 3 months. At 3 months, the subjects were categorized as responders, partial responders and non-responders to treatment by IASI. Various factors were narrowed down to see their effect on response, namely age, BMI, smoking habits, comorbidities, presence of clinical effusion, radiographic score, local knee tenderness, range of movement and socioeconomic status. One hundred twenty-four patients completed the study. 16.1 % showed 50 % or more improvement in WOMAC score at 3 months post IASI therapy, whereas 38.7 % of OA patients had more than 50 % improvement in VAS score. Out of all factors, range of movement, local knee tenderness and radiographic score of the affected joint are the three parameters which can predict the improvement in WOMAC score after 3 months of IASI therapy (P = 0.013, P = 0.045 and P = 0.000, respectively). Age of the patient can predict improvement in VAS at 3 months post IASI (P = 0.027). We conclude that age, range of movement, local knee tenderness and radiographic score of the affected joint can predict response to IASI after 3 months of IASI therapy.

Chondroprotective Factors in Osteoarthritis: a Joint Affair

“…There are several studies where these scores reveal patterns in chondroprotective response. Individuals with severe cartilage loss have a reduced likelihood of improved pain following intra-articular steroid injection [ 53 , 54 ]. Meanwhile, strontium ranelate inhibition of cartilage loss was more effective in patients with meniscal extrusion and bone marrow lesions than in those with meniscal extrusion alone [ 55 ].…”

“…Risk factors for OA, including age, sex, and trauma, may hint at the underlying mechanism and determine the broadly applicable stratification steps. Age is associated with inflammaging and senescence and predicts improvement in pain following corticosteroid injection for knee OA [ 54 ]. Mechanisms underlying pain differ in males and females, and, consequentially, the mechanisms underlying cartilage damage may also be modulated by sex.…”

Highly selective peripheral nerve radio frequency ablation for the treatment of severe knee osteoarthritis

“…In addition to conservative treatment, there are currently many invasive treatments for knee OA ( 1 ), such as knee lavage, hyaluronic acid injection, glucocorticoid injection, arthroscopic synovial cleanup, and knee resurfacing, all of which have different indications and disadvantages ( 8 ). Knee lavage, glucocorticoid injection, and hyaluronic acid injection are applicable to mild and moderate OA, and can stabilize the intra-articular environment, increase articular lubrication, relieve synovitis, and enhance secreting hyaluronic acid ( 9 , 10 ). Arthroscopic synovial cleanup and knee resurfacing are applicable to moderate and severe gonitis, and the latter is the final treatment for OA ( 11 ).…”

Terapias intervencionistas para manejo de dolor en Osteoartrosis de rodilla sintomática

“…A pesar de su uso extenso a través de los años, aún no está claro qué pacientes son respondedores y quiénes no a las inyecciones de corticoides IA de rodillas (12). Con el objetivo de optimizar y mejorar la selección de aquellos pacientes que más se benefician de esta terapia, Nibah y cols., en julio del 2016, publicaron un trabajo donde valoran pacientes mujeres con OA de rodilla y encuentran como factores predictores de respuesta positiva a mejoría del dolor con la terapia IA de corticoides a aquellos pacientes con mayor dificultad o restricción al movimiento (según la escala de WOMAC), mayor sensibilidad en la articulación afectada, mayor compromiso radiográfico y mayor edad.…”

“…Con el objetivo de optimizar y mejorar la selección de aquellos pacientes que más se benefician de esta terapia, Nibah y cols., en julio del 2016, publicaron un trabajo donde valoran pacientes mujeres con OA de rodilla y encuentran como factores predictores de respuesta positiva a mejoría del dolor con la terapia IA de corticoides a aquellos pacientes con mayor dificultad o restricción al movimiento (según la escala de WOMAC), mayor sensibilidad en la articulación afectada, mayor compromiso radiográfico y mayor edad. Por otro lado, el índice de masa corporal y la duración de los síntomas no mostraron una correlación como predictores de no respuesta al manejo (12).…”