A comparative study of patients undergoing total knee replacement with or without local corticosteroid injection for Pes anserine bursitis associated with osteoarthritis of the knee

Abstract

Pes anserine bursitis is one of the most important causes of periarticular pain. The prevalence of osteoarthritis together with Pes anserine bursitis has been reported to be as high as 75%. Total knee replacement for knee osteoarthritis provides the greatest improvement in quality of life in patients with more severe functional impairment. The treatment options for pes anserine bursitis includes local injections of local anaesthetic (such as lidocaine) or a long acting corticosteroid. In our study we compared the functional outcomes in patients with osteoarthritis undergoing Total knee replacement along with or without local steroid injections for associated pes anserine bursitis. The objectives were to compare the pre and post operative pain levels with Visual Analogue Scale scores and functional outcomes with the Oxford knee scores in both these groups. All patients were divided into 2 groups “Yes” and “No”, in a randomized fashion. The first group received a local injection at the site of the pes anserine bursitis along with total knee replacement surgery whereas the second group did not. It was observed that the pain scores in the “Yes” group, that received the local steroid injection were consistently lower than those in the “No” group, in the post operative follow up time intervals. However, this decrease in scores were not statistically significant. It was seen that both groups had a similar amount of significant improvement in functional scores at 1 month, and hence, the difference was insignificant. Local corticosteroid injections combined with Total knee replacement for pes anserine bursitis associated with osteoarthritis of the knee are safe but the efficacy of this treatment protocol could not be proved in our study. The results were not statistically significant probably due to the small sample size of the study.