Abstract
ObjectivesIntraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion.MethodsOne-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month and at one year were evaluated. Clinical responder were consider in subjects with enough improvement to carry out normal daily activities with pain VAS<40mm.ResultsOne hundred and thirty-two patients were included.A significant number of patients (61.4%) improved pain at one year following the protocol established in this study. Pain and ultrasound synovial fluid at one month appeared to predict the response at one year. The Lequesne index and the percentage of body fat were independently associated to pain at one year while the Lequesne index and ultrasound synovial hypertrophy were independently related to the presence of synovial fluid at one year.ConclusionsThe status regarding pain or ultrasound synovial fluid at one month after an intraarticular joint injection appeared to predict the status at one year in patients with knee osteoarthritis and synovial effusion.
Highlights
Osteoarthritis (OA) is a disabling musculoskeletal disorder and knee OA the most prevalent condition[1]
The status regarding pain or ultrasound synovial fluid at one month after an intraarticular joint injection appeared to predict the status at one year in patients with knee osteoarthritis and synovial effusion
OA prevalence increases with age and sometimes patients suffering from symptomatic knee OA have cardiovascular comorbidities limiting treatment options[2,3,4]
Summary
Osteoarthritis (OA) is a disabling musculoskeletal disorder and knee OA the most prevalent condition[1]. In daily clinical practice intraarticular corticosteroid injections (IACI) are often used as a treatment for pain relief [5] but, 95% of rheumatologists use IACI as a therapeutic technique[6], there is not a consensus on the pattern of administration. Different societies recommend IACI of long-acting corticosteroid as a treatment option for knee osteoarthritis [7, 8] and especially for knee pain flares if accompanied by effusion[9]. Our purpose was to evaluate the frequency of patients with pain relief at one year of follow-up in a homogeneous group of knee OA patients with joint effusion in daily clinical practice using a preestablished protocol of IACI for flares, and to identify clinical factors associated to a better intraarticular injection response at one year of follow-up
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