Intra-Articular Steroid Injection for Patients with Hip Osteoarthritis: A Systematic Review and Meta-Analysis.

Hui-Ming Zhong,Guang-Feng Zhao,Zhi-Jun Pan,Xin-Yu Li,Jun-Fan Lin,Tiao Lin,Si-Qi Zhao,Xin-Xin Zhang

doi:10.1155/2020/6320154

Abstract

Purpose The aim of this current review was to confirm the efficacy of intra-articular steroid therapy (IAST) for patients with hip osteoarthritis (OA) and discuss the duration and influential factors of IAST. Methods Online databases (Medline, EMBASE, and Web of Science) were searched from inception to May 2019. Both randomized controlled trials (RCTs) and noncontrolled trials assessing the efficacy of hip IAST on pain were included. Common demographics data were extracted using a standardized form. Quality was assessed on the basis of Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. Results 12 trials met the inclusion criteria. According to data from individual trials, IAST had significant efficacy on hip OA in both immediate and delay pain reduction, which persisted up to 12 weeks after IAST. The influences of the baseline severity of hip OA or synovitis and injection dose or volume on the clinical outcome of IAST were still controversial. The IAST appeared to be well tolerant by most of the participants. Conclusion IAST was proved to be an efficacious therapy in both immediate and delay pain reduction for hip OA patients within 12 weeks. The longer follow-up data of efficacy and safety and potentially influential factors are still unclear and needed further confirmation.

Highlights

Hip osteoarthritis (OA), involving major structural changes of the joint, is one of the most common articular diseases, and the prevalence increases with age [1]. e hip pain and functional disorders in this population result in great troubles in their daily activities and life quality [2]
Published data related to Intra-articular steroid therapy (IAST) on hip OA patients were varied and the efficacy of pain reduction in the long term is rarely evidenced. e rationale of applying IAST is mainly based on the evidence from knee OA patients
A previous systematic review [6] reported an efficacious pain reduction with IAST in hip OA patients, on which the treatment came into effect one week after injection, and the beneficial efficacy on pain relief decreased thereafter

Summary

Introduction

Hip osteoarthritis (OA), involving major structural changes of the joint, is one of the most common articular diseases, and the prevalence increases with age [1]. e hip pain and functional disorders in this population result in great troubles in their daily activities and life quality [2].To reduce pain and restore function, the main therapy methods for hip OA comprise surgical interventions such as total hip replacement (THR) operation and nonsurgical interventions such as exercise therapy [3] and medication therapy [4]. Patients with THR might need a revision of their hip replacement in the future, while nonsurgical interventions before surgery with pain reduction are supposed to delay primary replacement or avoid revision surgery [5]. Intra-articular steroid therapy (IAST) is likely to be an available candidate to supply a local analgesic effect for OA patients. Published data related to IAST on hip OA patients were varied and the efficacy of pain reduction in the long term is rarely evidenced. A previous systematic review [6] reported an efficacious pain reduction with IAST in hip OA patients, on which the treatment came into effect one week after injection, and the beneficial efficacy on pain relief decreased thereafter. This review only summarized five studies with 346 participants during a short-term follow-up, rendering that it was still

Methods

Results

Conclusion