Intra articular methylprednisolone acetate injection efficacy in the treatment of primary knee osteoarthritis at Hue Central Hospital and Hospital of Hue University of Medicine and Pharmacy

Abstract

Introduction/Background: Osteoarthritis is still an incurable disease, the current treatment is to reduce clinical symptoms. The intra articular glucocorticoid injection in knee osteoarthritis makes the inflammatory process self-limiting and improves pain symptom. Objectives: To evaluate the efficacy and safety of intra articular methylprednisolone acetate injection in treatment of primary knee osteoarthritis. Materials and Methods: Prospective descriptive study of 88 knee joints (34 joints in study group, 54 joints in control group) was diagnosed with primary osteoarthritis according to the American College of Rheumatology (ACR) classification criteria and in Kellgen & Lawrence grade II, III. The patient was assessed about clinical features, subclinical features and the VAS score, Lequesne index at the initial of the study and 7 days later. Results: The analgesic effect was higher in the group of intra articular methylprednisolon injection with statistically significant difference (∆VAS of the study group and the control group were 38.65 ± 9.25; 25.11 ± 9.26, respectively, with p < 0.05). The improving of knee function was higher in the group of intra articular methylprednisolon injection with statistically significant difference (∆Lequesne of the study group and the control group were 7.00 (5.00 – 8.00); 4.00 (3.00 – 5.00), respectively, with p < 0.05). The incidence of complications in the study group was 1/34 (2.94%) with post – injection pain. The improvement of VAS is better in patient with severe pain than those with moderate pain (p < 0.05) and correlated to the initial value of Lequesne (r2 = 0,162, respectively, with p < 0.05). The improvement of Lequesne correlated to the joint fluid thickness in ultrasound (r2 = 0.102, p < 0.05). There is no relation between efficacy of treatment and site of knee joint, radiology stage and synovial membrane thickness (p > 0.05). Conclusions: The intra articular methylprednisolone acetate injection in treatment of primary knee osteoarthritis is a safe treatment and has significant, clearly effect in pain relief and physical function improving after 7 days. The improvement of VAS is better in the patient with higher initial value of VAS, Lequesne and the improvement of Lequesne is better in the patients with more synovial thickness in ultrasound. Key words: Knee osteoarthritis, intraarticular injection, methylprednisolon acetate