Radiographic patterns and response to corticosteroid hip injection

Plant, Michael; Borg, Åke; Dziedzic, Krysia; Saklatvala, J.; Dawes, P. T.

doi:10.1136/ard.56.8.476

Cited by 84 publications

(32 citation statements)

References 21 publications

(14 reference statements)

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“…This study was underpowered to detect predictors of response among 12 variables. Similar conclusions were made regarding a small prospective cohort of 27 patients with hip OA assessed at baseline, 2, 12 and 26 weeks following hip IA lignocaine and methylprednisolone (63). The main outcome measure was pain measured on VAS.…”

Section: Radiographic and Mri Assessmentsupporting

confidence: 50%

Targeting Care

Eyles

Lucas

Hunter

2013

Rheumatic Disease Clinics of North America

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Important points and objectives for recall:• Numerous studies have explored patient characteristics including: body mass index, psychological factors, muscle strength, tibiofemoral alignment, radiographic changes and signs of inflammation as potential predictors of response to non-surgical interventions for management of hip and knee OA.• Often the sample sizes utilized by these studies were inadequate to yield sufficient numbers of responders to the interventions to allow for analysis of the potential predictors identified.• A number of well-designed studies were adequately powered to provide some evidence for clinical characteristics that did or did not predict response to non-surgical interventions for participants with hip and knee OA. SynopsisInternational evidence-based guidelines recommend a multitude of non-surgical treatment options for the management of OA. In the face of so many choices, it would be helpful for clinicians to be able to base treatment decisions on the identification of specific clinical presentations that foretell greater likelihood of success following a given treatment. This review summarizes the evidence available for patient characteristics that have been analysed as potential predictors of response to non-surgical interventions for patients with hip and knee OA. The specific variables targeted for this review include: body mass index, psychological factors, muscle strength, tibiofemoral alignment, radiographic changes and signs of inflammation. Several studies provide moderate to good evidence of potential predictors of response to non-surgical treatments, while areas for future research are illuminated.

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Section: Radiographic and Mri Assessmentsupporting

confidence: 50%

Targeting Care

Eyles

Lucas

Hunter

2013

Rheumatic Disease Clinics of North America

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“…The use of corticosteroids in hip OA is controversial, because these drugs are short acting and may cause several adverse effects (7,8). Therefore, drugs with minimal side effects are warranted.…”

Section: Introductionmentioning

confidence: 99%

Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Abate¹,

Pelotti²,

Amicis³

et al. 2008

Upsala Journal of Medical Sciences

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Background: Viscosupplementation (VS) with hyaluronic acid (HA) is largely used for knee osteoarthritis therapy, but the evidences for its usefulness in hip osteoarthritis (OA) are limited. Methods: In this review, an extensive search of published trials on VS in hip OA was performed. From the selected papers the following data were extracted: sample size, inclusion / exclusion criteria, treatment procedures, evaluation methods, follow-up duration and clinical outcomes. Results: The level of evidence was low in quite all the trials (no placebo controlled groups). A reduction of pain and an improvement of function after 3 months, persistent in the long term (12 -18 months), was observed. Patients with mild morphological alterations responded better to therapy. Side effects were negligible, and were limited to pain and a sensation of heaviness in the injection site. No clear differences among Low (LMW) and High Molecular Weight (HMW) HA preparations were found in the clinical outcomes. However, for HMW-HA preparations, a lower number of injections was, in general, necessary in order to reach the therapeutic effect. Conclusions: Despite the initial promising results, some questions still remain open : 1) the characteristics of responders must be more precisely defined; 2) the treatment schedules, at present mainly based on the individual clinical experience, need a proper and accepted standardization. Finally, larger and placebo controlled trials are necessary to confirm the efficacy of VS in hip OA.

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“…In conjunction with an intraarticular injection of a long-acting anesthetic, steroids can be used for diagnostic purposes to distinguish intrinsic from extrinsic sources of pain such as that originating in the spine [8,11,20,22]. The duration and efficacy of pain relief then can be indicative of the source of pain [9,28,32,43]. Although steroid injections in the hip are not recommended in the treatment guidelines provided by the American College of Rheumatology for OA of the hip, they can be helpful in clinical practice when patients with moderate or end-stage OA are not willing or suitable to undergo a THA in the short term [2].…”

Section: Introductionmentioning

confidence: 99%

“…Steroid injections of the hip can be administered for diagnostic [8,11,20,22] and therapeutic reasons [9,28,32,43], particularly to alleviate inflammatory symptoms that can be associated with moderate or end-stage osteoarthritis (OA) of the joint. The radiographic findings of OA are not always conclusive or in relation to the symptoms expressed by the patient.…”

Section: Introductionmentioning

confidence: 99%

Is the Infection Rate in Primary THA Increased After Steroid Injection?

Meermans¹,

Corten²,

Simon³

2012

Clinical Orthopaedics &Amp; Related Research

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Background Injection of the hip is performed for diagnostic and therapeutic reasons. Articular cartilage deterioration and increased risk of prosthetic infection have been reported with steroid injections. However, the literature contains contradictory reports on an increased risk of infection after a subsequent THA. Questions/PurposesWe asked whether intraarticular steroid injection increased the rate of infection of a subsequent THA. Methods We retrospectively reviewed records of 175 patients in whom intraarticular steroid injections were given under strictly aseptic conditions using a lateral approach within 1 year before THA. These patients were matched with others from our database who had not received an injection for comorbidities, and for American Society of Anesthesiologists score, age, BMI, sex, type of implant, and year of THA.

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Radiographic patterns and response to corticosteroid hip injection

Cited by 84 publications

References 21 publications

Targeting Care

Targeting Care

Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Is the Infection Rate in Primary THA Increased After Steroid Injection?

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