Intra-articular Methylprednisolone Research Articles

Comparing The Clinical Efficacy Of Intra Articular Shoulder Injection Verses Combined Suprascapular And Axillary Nerve Block For Adhesive Capsulitis

Objective: To evaluate the effectiveness of combined suprascapular nerve block with axillary nerve block and intra-articular steroid injection for the treatment of adhesive capsulitis. Study Design: Cross sectional study Place and Duration of the Study: Outpatient Department (OPD) of Ghurki Hospital from April 3, 2024, to September 5, 2024. Methodology: Patients in Group A were subjected to Ultrasound (USG) guided Selective Sensory Nerve Block (SSNB) in conjunction with Axillary Nerve Block (ANB), while patients in Group B received Intra-Articular (IA) methylprednisolone. Evaluations were conducted at baseline and at the 2nd, 4th, 6th, 8th, and 12th weeks post-intervention, utilizing the Visual Analog Scale (VAS), active and passive Range of Motion (ROM) of the shoulder, and the Shoulder Pain and Disability Index (SPADI). Statistical significance was assessed using Chi-square for qualitative variables and unpaired or paired t-tests for quantitative data. A p-value of less than 0.05 was considered indicative of statistical significance. Results: In this study of 80 participants, Group A showed significantly better outcomes than Group B over 12 weeks. Baseline pain scores were similar (7.50 ± 1.15 in Group A vs. 7.60 ± 1.20 in Group B, p=0.75), but by week 12, Group A's pain reduced to 2.60 ± 1.00 compared to 4.50 ± 1.20 in Group B (p<0.001). Group A also had greater improvements in active and passive range of motion. For example, active abduction increased to 150.0 ± 10.0 degrees in Group A vs. 135.0 ± 11.0 degrees in Group B (p=0.003), and passive abduction to 160.0 ± 15.0 degrees vs. 135.0 ± 16.0 degrees (p<0.0005). Overall, Group A had significantly better improvements in pain and mobility. Conclusion: The study concludes that IA steroid injection and combined SSNBwith ANB treat AC well. Long-term results are better with SSNB and ANB than steroid injections. Thus, SSNB and ANB can supplement exercise treatment and replace IAS if necessary. Keyword: Adhesive Capsulitis, Frozen shoulder, Suprascapular Nerve Block, Axillary Nerve Block, Intra-Articular Corticosteroid Injection, Treatment

Nonsurgical Knee Osteoarthritis Treatments for Reducing Inflammation as Measured on MRI Scans: A Systematic Review of Randomized Controlled Trials.

Knee osteoarthritis (OA) is a debilitating condition, and synovitis is a structural marker of disease progression that can be identified on magnetic resonance imaging (MRI). Nonsurgical therapies have been developed with the goal of targeting this inflammation to reduce pain and slow disease progression. To review current randomized controlled trials (RCTs) that measured changes in pain outcomes and synovitis on MRI scans after nonsurgical treatment for persons with knee OA. Systematic review; Level of evidence, 1. The PubMed database was searched using the terms "knee osteoarthritis AND (synovitis OR inflammation)" for RCTs published between 2012 and 2022. Included were studies that collected both pain outcomes and quantitative measurements of synovitis on MRI scan before and after treatment; studies that investigated surgical treatments were excluded. We calculated standardized response means (SRMs) to analyze the effect sizes of treatment on pain and synovitis outcomes; SRMs were classified as having low responsiveness to treatment if <0.5, moderate responsiveness to treatment if between 0.5 and 0.8, and large responsiveness to treatment if >0.8. Included in the review were 9 RCTs. Vitamin D and exercise therapy were the only 2 treatments that improved both pain and synovitis outcomes in comparison with their respective control groups. Statistically significant group differences in favor of treatment were seen in changes in pain after lutikizumab (anti-interleukin-1α/β dual variable domain immunoglobulin; SRM, 0.22; P = .050), allogenic human chondrocytes transduced with retroviral vector encoding transforming growth factor-β1 (P = .0119 at 12 weeks, P = .120 at 52 weeks, and P = .0074 at 72 weeks), and Curcuma longa (turmeric; SRM, 0.35; P = .039 on the visual analog scale for pain and SRM, 0.47; P = .006 on the Western Ontario and McMaster Universities Osteoarthritis Index pain subscore). One study reported a statistically significant group difference in synovitis only after treatment with intra-articular methylprednisolone (P = .01 at 14 weeks and P = .0006 at 26 weeks). Only vitamin D and exercise therapy were found to improve pain and synovitis after treatment in this review. Further research is needed to validate these findings and investigate alternative treatments for reducing pain and synovitis in persons with knee OA.

Analgesic effects of intraarticular anaesthetic lidocaine and methylprednisolone versus methylprednisolone alone following knee arthroscopy.

Knee arthroscopy is a widely practiced orthopaedic procedure known for its minimally invasive approach, allowing quicker recovery times and less postoperative discomfort than traditional open surgeries. However, managing postoperative pain remains a critical aspect of patient care and satisfaction. The main objective of this research is to examine the relationships between patient demographics (age, gender, BMI) and early postoperative outcomes, including pain, physiotherapy, and walking. Randomized data collection, clinical trial study of 2 groups of patients. The patients were split into lidocaine 1 % 16 ml + methylprednisolone 160 mg 4 ml) and (methylprednisolone only 160 mg 4 ml) groups. All patients in both groups were queried about age, gender, BMI, and pain on the first, third, and 15th days following surgery. All patients were tested for physiotherapy on the second, third, and fourth postop days. After surgery, walking was tested on the third, fourth, and fifth days. Significant differences in postoperative pain relief and physiotherapy initiation times were observed. There are notable associations between treatment groups and recovery metrics, such as pain levels and mobility on various days' post-surgery. Significant demographic influences (age, gender, BMI) on recovery outcomes are observed, particularly in walking and pain at day 15 post-operation. lidocaine and methylprednisolone improve postoperative pain relief and functional recovery in knee arthroscopy patients, with most experiencing reduced pain early post-surgery (early physiotherapy) and an expedited return to walking (decreased morbidity). Patients taking just methylprednisolone recovered slower. Age, gender, and BMI affected pain and walking abilities post-operation but not physiotherapy time, underscoring the personalised approach needed in postoperative treatment.

Intra-articular pulsed radiofrequency with methyl prednisolone injection in chronic sacroiliac joint arthritis: A randomized clinical trial

ABSTRACT Background Sacroiliac joint pain (SIJP) is an important cause of low back pain and seriously affects the patients’ quality of life. Therefore, it is urgent to find effective treatment methods. The goal of our research was to assess the effectiveness of radiofrequency ablation combined with steroid injection versus steroid injection alone in the treatment of chronic sacroiliac joint arthritis (SIJ) pain. Methods Sixty patients with chronic SIJ pain were divided into two groups randomly: Group RF (n = 30) received intraarticular RF + methylprednisolone, while Group C (n = 30) received intraarticular methylprednisolone alone. The Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), and Patient Global Impression of Change Scale (PGIC) were followed up at each observation time (before the intervention, 1 month, 3 months, 6 months, 9 months, and 12 months). Results The NRS and ODI reduced following treatment compared to pretreatment values; however, the PGIC increased in both groups. The NRS in the RF group reduced significantly than in the control group after treatment at nearly all time intervals after the third month with p = 0.015*, 0.004*, 0.049*, and 0.025*, respectively. After the first month, the difference in PGIC score between the two groups becomes statistically significant at nearly all time intervals with p < 0.05. At nearly all time intervals, the RF group had higher PGIC scores. Conclusion PRF ablation with methylprednisolone injection is a safe and efficient treatment for sacroiliac pain. It has the potential to considerably reduce sacroiliac pain, lower ODI, raise PGIG, and improve physical and mental quality of life.

Efficacy of intra-articular methylprednisolone along with platelet rich plasma vs. platelet rich plasma in early osteoarthritis: a retrospective study

Background: Increased prevalence as well as burden affecting osteoarthritis of knee joint has led to increase in concerns regarding safety of various pharmacological methods. Hence, there is an increase in demand for newer and effective strategies for treatment and manage­ment. Thus, a novel alternate for treatment is required that might repair damage to cartilage rather than simply reduce related symptoms. The aim of this study was to study the efficacy of intra-articular methylprednisolone along with platelet rich plasma versus platelet rich plasma in early knee osteoarthritis. Methods: This retrospective study was conducted on 60 patients diagnosed with initial stages of osteoarthritis of knee according to Kellgren-Lawrence classification. Patients age range was between 40 to 80 years who were divided into 2 groups; group I: It contained 30 subjects treated with intra-articular injections of Platelet Rich Plasma in combination with methylprednisolone and group II: comprised of 30 patients treated with intra-articular injection of Platelet rich Plasma alone. Clinical data pertaining to medical history, VAS and KOOS scores were collected. Statistical analysis was performed using the student’s t test. Results: Statistically significant improvements in VAS and KOOS score values were observed on assessment of scores at baseline, 1, 3 and 6 months intervals, respectively. Conclusions: It can be concluded from the study that a combination therapy of intra-articular injection of combination of PRP with methylprednisolone yields superior results when compared to use of PRP injections alone.

Short Term Effectiveness of Intraarticular Injection of Methylprednisolone Acetate in Subacromial Impingement Syndrome in A Tertiary Care Hospital

Objective: To determine the effectiveness of intraarticular injection of methylprednisolone acetate in subacromial impingement syndrome. Study Design: Descriptive Case Series Place and Duration: Study was conducted in Orthopaedic Unit Ayub Medical Teaching Institute Abbottabad and MTI, Hayatabad Medical Complex Peshawar for one year duration from February 2020 to February 2021. Methods: Total 100 patients of newly diagnosed subacromial impingement syndrome were enrolled in this study. Patients were aged between 20-60 years. Patients details demographics age, sex and body mass index were recorded after taking informed written consent. Patients did not receive any treatment before were included. Effectiveness of intraarticular injection of methyl prednisolone acetate was measured by using visual analogue scale (VAS) for pain intensity from 0 to 10 by VAS score after 4 weeks.Completedata was analyzed by SPSS 22.0 version. Results: Mean age of the patients was 38.14±7.44 years with mean BMI 25.64±18.9kg/m2. Among 100 cases, 75 (75%) patients were males and 25 (25%) were females. Diabetic patients were 25 (25%) and 14 (14%) patients were gout among all cases. Mean VAS score before treatment was 6.14±4.84 and after treatment VAS score was reduced to 4.41± 3.64. After follow up of 4 weeks VAS score was decreased to 1.11±3.65. Satisfaction among patients were 90 (90%). Conclusion: We concluded in this study that for the treatment of subacromial impingement syndrome, intraarticularinjection of methylprednisolone acetate was effective and useful. It was also observed that VAS score among patients were reduced significantly with should pain. Keywords: Intra articular methylprednisolone injection, Subacromial impingement syndrome, Effectiveness, Visual analogue scale

Intra-Articular Methylprednisolone Injection for Advanced Osteoarthritis in Geriatric Patient Population

Background: We aimed to investigate the effect of intra-articular methylprednisolone injection on pain and functional outcomes and the number of outpatient clinic admissions in patients with advanced knee osteoarthritis in the geriatric age group. Method: The files of 78 patients over the age of 65 who were administered intra-articular methylprednisolone injection with the diagnosis of primary gonarthrosis between 2018 and 2020 were analyzed retrospectively. Age, gender, and affected side of the patients were recorded. The number of outpatient clinic admissions, VAS and Womac scores before and after injection were evaluated statistically. Results: Of the patients, 18 were male (24.7%) and 55 were female (75.3%). The mean age was 74.95±7.11 years. The values of the patients' WOMAC and VPS scores at the 1st and 3rd months were significantly lower than the pre-injection period. Compared to the number of outpatient visits in the 6-month period before injection, the decrease in the number of outpatient visits in the 6-month period after injection was statistically significant. A strong positive correlation was found between the number of outpatient visits before injection and the first VPS score. Conclusions: In geriatric patients with advanced-stage osteoarthritis who do not accept total knee arthroplasty, intra-articular methylprednisolone injection may be a feasible method that reduces pain and the number of outpatient visits in the short term.

Ultrasound Guided Suprascapular Nerve Block versus Intra-articular Steroid Injection in the Treatment of Periarthritis Shoulder: A Randomised Clinical Trial

Introduction: Suprascapular Nerve Block (SSNB) and Intra-articular (IA) steroid injection are used for management of Periarthritis (PA) of shoulder with variable results. Aim: To compare the efficacy of SSNB and IA steroid injection for management of PA shoulder. Materials and Methods: In this randomised clinical trial, 100 patients of PA shoulder from Physical Medicine and Rehabilitation (PMR) Outpatient Department (OPD) were enrolled over the period of 18 months and were divided in two equal groups using computerised block randomisation. Group A patients received IA methylprednisolone while Group B patients were subjected to Ultrasound (USG) guided SSNB. Assessment was done at baseline and at 1, 4 and 12 weeks after the intervention, using Numerical Pain Rating Scale (NPRS), active and passive Range Of Motion (ROM) of shoulder and Shoulder Pain And Disability Index (SPADI). Statistical significance was determined by Chi- square for qualitative variables and by unpaired t-test or paired t-test for quantitative variables. The p&lt;0.05 was taken as a level of statistical significance. Results: Both groups had significant improvement (p&lt;0.0005) in pain, ROM and functional index at all follow-ups. Comparison between the groups revealed a better outcome in Group A, in terms of NPRS, SPADI score, internal and external rotations at 1, 4 and 12 weeks (p&lt;0.0005). Both the groups were comparable in terms of abduction, flexion and extension at first week (p&lt;0.0005) with Group A showing better improvement at subsequent follow-up. Conclusion: Both SSNB and IA steroid injection can be used for treatment of PA shoulder but IA steroid injections gave better results as compared to SSNB. SSNB may be used as an adjunct to exercise therapy and as an alternative to IA steroid injection if required.

Pulmonary response of severely asthmatic horses after intra-articular administration of methylprednisolone.

Intra-articular (IA) administration of corticosteroids is performed routinely in equine practice. The lung function of severe asthmatic horses has recently been shown to be improved by IA triamcinolone acetonide (TA). We therefore hypothesised that IA methylprednisolone acetate (MPA), another commonly used corticosteroids, would also decrease the airway obstruction in severe asthmatic horses. To compare the effects of intra-articular (IA) and intramuscular (IM) methylprednisolone acetate (MPA) administration on lung function and serum cortisol levels in horses with severe asthma. Randomised and controlled experiments on severe asthmatic research animals. Severe asthmatic horses in exacerbation were administered 200mg of MPA either intramuscularly (n=6) or via intra-articular injections in the tarsocrural joints (n=6; 100mg/joint). Serum cortisol concentration and pulmonary function was measured for 8days. A significant decrease in pulmonary resistance in the IA group (P=.003, mean diff 1.14) on day 1 in comparison with baseline was observed. A significant decrease from baseline was also observed on serum cortisol values in the IA group 6hours after injection (P=.001, mean diff 44.5), and at day 1 (P=.003, mean diff 45.1). Joint health was not evaluated in the current study and the physiological response of the severe asthmatic horses might deviate from that of the milder forms of asthma. MPA IA administration improves the lung function of severe asthmatic horses. However, this effect was mild and of a short duration.

Management of autoimmune ear disease and idiopathic polyarthritis with adalimumab

Autoimmune inner ear disease (AIED) is a rare form of sensorineural hearing loss of autoimmune origin and responding to immunosuppressive therapy with corticosteroids or other immunosuppressants. Novel treatment approaches include intratympanic steroids and biological response modulators against tumor necrosis factor-α. We present a case of AIED, who concomitantly developed seronegative inflammatory polyarthritis (IPA). The treatment for IPA was initiated with methotrexate, hydroxychloroquine, and intra-articular methyl prednisolone. When there was no adequate response, the patient was started on adalimumab, which in addition to IPA also showed beneficial effects on AIED.

Comparison of intra articular autologous platelet-rich plasma with steroids in osteoarthritis knee: Experience from a North Indian tertiary care center

Background: Intra-articular (IA) platelet-rich plasma (PRP) is a promising treatment option for knee osteoarthritis (OA). It accelerates the process of healing, ligament repair, cartilage regeneration, and bone formation when given in supraphysiological doses. The aim of this study was to compare the efficacy of IA PRP versus IA methylprednisolone acetate (MPA) in patients with knee OA. Methods: Open labeled prospective observational study was conducted on 60 patients with Kellgren-Lawrence Grade 2 and 3 OA knee, who fulfilled the ACR classification criteria for knee OA. Thirty patients were given IA PRP (6 ml) and 30 received IA methyl prednisolone (80 mg) at baseline line, which was repeated at 12 weeks. The primary endpoint was an improvement in Western Ontario and McMaster Universities Index (WOMAC) and 100 mm Visual Analog Scale (VAS) pain at 24 weeks postinjections. Results: The mean change in VAS pain and total WOMAC score from baseline to 24 weeks was 32.9 ± 12.1, 31.8 ± 14.7 for PRP group, and 12.9 ± 5.9, 7.5 ± 5.5 for MPA group, which was statistically significant (P Conclusions: Treatment with IA PRP showed sustained improvements in WOMAC and VAS scores compared to IA steroids. PRP is an effective treatment for functional status and pain in moderate knee osteoarthritis.

Efficacy of intra-articular injection of methylprednisolone in patients with osteoarthritis of the knee in southern district of India

Background: Osteoarthritis (OA) is a most common form of arthritis wherein chronic progressive degenerative changes occur in the articular cartilage of the joint which leads to restriction of joint function and poor life quality and it is globally prevalent causing pain and functional disability. Intra-articular corticosteroids are usually administered to candidates who do not show symptomatic relief to conservative line of management. Aims and Objectives: The objective of the study is to assess the efficacy of intra-articular injection of methylprednisolone acetate in patients with OA of the knee. Materials and Methods: Patients of all age and gender diagnosed with primary OA of knee with visual analog scale (VAS) pain score seven and more than seven with X-ray evidence of osteoarthropathy of knee with Kellgren Lawrence classification one-three, patients not satisfied with anti-inflammatory drugs and physiotherapy were included in the study. Study participants were asked for self-assessment of pain and mark on the VAS and interpretation of scoring was statistically analyzed. Results: Thirty study participants were enrolled for the study among them, the male and female were 56.67% and 43.33%, respectively. The mean age of the study participants was 59.2 ± 11.79 years. The mean VAS pain score before intra-articular methylprednisolone acetate was 9.37 ± 0.81 and there was gradual decrease in pain score after intra-articular injection over time in 2, 4, 8, 12, and 24 weeks. Conclusion: Intra-articular methylprednisolone acetate had revealed good efficacy in patients with OA knee with chronic pain without adverse effects.

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

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 &amp; 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 &lt; 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 &lt; 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 &lt; 0.05) and correlated to the initial value of Lequesne (r2 = 0,162, respectively, with p &lt; 0.05). The improvement of Lequesne correlated to the joint fluid thickness in ultrasound (r2 = 0.102, p &lt; 0.05). There is no relation between efficacy of treatment and site of knee joint, radiology stage and synovial membrane thickness (p &gt; 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

Evaluating the Outcome of Two Different Regimes in Adhesive Capsulitis: A Prospective Clinical Study

Objective: Adhesive capsulitis or frozen shoulder is a painful condition affecting up to 5% of the general population. We conducted this study with the aim of evaluating the results of physiotherapy plus intra-articular methylprednisolone injection versus physiotherapy alone in idiopathic frozen shoulder. Methods: This prospective clinical study was conducted in a tertiary care center between August 2016 and August 2018. Patients who were diagnosed with idiopathic frozen shoulder were included in the study, and each patient was randomly allocated to one of two groups: physiotherapy alone (group A) and physiotherapy plus intra-articular steroid injection (group B). Results: A total of 52 cases diagnosed with idiopathic frozen shoulder were included and treated with the two modalities. There was a significant improvement in group B compared to group A at 6 weeks and 3 months in the range of flexion, abduction, and external rotation. The Shoulder Pain and Disability Index showed improvement in both pain and disability score in group B ­compared to group A, and improvement was significant at 6 weeks and 3 months. Conclusion: The results demonstrate the advantages of physiotherapy plus intra-articular steroid injection in idiopathic frozen shoulder. The predictability of results with physiotherapy plus intra-articular steroid injection in selected patients is excellent, and it is a better modality of treatment compared to physiotherapy alone.

Effectiveness of Intra-articular Steroid Injection in Treatment of Idiopathic Frozen Shoulder Followed by Physiotherapy and Home Exercise Program.

Introduction: Idiopathic frozen shoulder (IFS) is a common chronic and disabling condition of shoulder pain characterized by progressive loss of active and passive range of motion (ROM) with unclear pathogenesis. The ideal treatment protocol is still controversial but commonly used treatment includes single agent or combination of oral non-steroid anti- inflammatory drugs (NSAIDS), oral steroids, intra-articular steroid injection and physiotherapy.&#x0D; Objective: The objective of this study was to evaluate the effectiveness of intra-articular methylprednisolone injection for pain and ROM in patients suffering from idiopathic frozen shoulder who did not respond to oral NSAIDS with or without oral steroid.&#x0D; Methodology: A total of 70 patients suffering from IFS were enrolled in this cross sectional study from May 2017–October 2018 from outpatient department of orthopaedic and physiotherapy of Koshi Zonal Hospital. All the patients underwent treatment protocol that comprised of Intra-articular steroid injection followed by five days of oral NSAIDS along with five days regime of physical therapy at the physiotherapy centre, followed by home exercise program. Each patient was followed up at every two weeks interval from intra-articular injection till 6th week. Each patient was evaluated for range of motion (ROM), Numerical Pain Rating Scale (NPRS) and Shoulder Pain and Disability Index (SPADI) before the treatment protocol and at every follow up visit. Data was analyzed using Microsoft Excel Program.&#x0D; Results: All patients enrolled for the study had satisfactory response. The mean age of the patient was 51.8 years (range 40-65 years). The mean age of the 26 male patients was 54 years (range 45-65), whereas the mean age of 44 female patients was 50.5 years (range 45-60). Mean duration of illness was 26.5 weeks (range 18-32 weeks), SPADI before medication was 83.14, at 2nd week was 50.92, at 4th week was 38.63 and at 6th week was 27.22.&#x0D; Conclusion: Combination of intra-articular methylprednisolone injection, physiotherapy and home exercise program is effective in IFS for rapid improvement in pain and ROM.

Efficacy of intraarticular steroid injection in knee osteoarthritis using knee society score and visual analog score

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Osteoarthritis of knee is a chronic degenerative joint disease which leads to pain, swelling, stiffness and decreased quality of life. The purpose of this study was to assess the effect of intra-articular steroid injection for osteoarthritis knee by using knee society score (KSS) and visual analog scale (VAS).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective study of 38 patients (44 knees) diagnosed with osteoarthritis of knee were given 80mg of intra-articular methylprednisolone injection. The outcome was assessed using KSS and VAS before the injection and 3 months post injection.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean VAS improved 3 months post injection whereas there was no improvement in the mean KSS. The scores of VAS 3 months post injection were statistically significant whereas the KSS scores were statistically insignificant compared with the pre injection values.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Intra-articular steroid injection for osteoarthritis of knee produces significant pain relief for most patients even in severe cases but this not translate to better functional outcomes.&lt;/p&gt;

Comparison of efficacy of intraarticular polyacrylamide hydrogel and methylprednisolone acetate in patients with knee osteoarthritis

Purpose: The aim of this study was to compare and evaluate the efficacy of intraarticular methylprednisolone acetate and an intra-articular polyacrylamide hydrogel in patients with different stages of knee osteoarthritis. Materials and Methods: Patients with symptomatic knee osteoarthritis and history of failed pharmacotherapy or physiotherapy interventions were included in this study. The first 64 consecutive patients got intra-articular polyacrylamide hydrogel, the latter 79 consecutive patients got intra-articular methylprednisolone acetate. Patients were evaluated by WOMAC score and self-assessment questions. Results: There was no statistically significance difference between groups when WOMAC scores and answers of self-assessment questions were compared. Conclusion: Intra-articular use of polyacrylamide hydrogel was not superior to methylprednisolone acetate, for patients with knee osteoarthritis.

Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial.

Various systematic reviews have recently shown that intra-articular platelet-rich plasma (IA-PRP) can lead to symptomatic relief of knee osteoarthritis for up to 12 months. There exist limited data on its use in small joints, such as the trapeziometacarpal joint (TMJ) or carpometacarpal joint (CMCJ) of the thumb. A prospective, randomized, blind, controlled, clinical trial of 33 patients with clinical and radiographic osteoarthritis of the TMJ (grades: I-III according to the Eaton and Littler classification) was conducted. Group A patients (16 patients) received 2 ultrasound-guided IA-PRP injections, while group B patients (17 patients) received 2 ultrasound-guided intra-articular methylprednisolone and lidocaine injections at a 2-week interval. Patients were evaluated prior to and at 3 and 12 months after the second injection using the visual analogue scale (VAS) 100/100, shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (Q-DASH), and patient's subjective satisfaction. No significant differences between the baseline clinical and demographic characteristics of the 2 groups were identified. After 12 months' follow-up, the IA-PRP treatment has yielded significantly better results in comparison with the corticosteroids, in terms of VAS score (P = 0.015), Q-DASH score (P = 0.025), and patients' satisfaction (P = 0.002). Corticosteroids offer short-term relief of symptoms, but IA-PRP might achieve a lasting effect of up to 12 months in the treatment of early to moderate symptomatic TMJ arthritis.

Comparison of Efficacy of Lateral Branch Pulsed Radiofrequency Denervation and Intraarticular Depot Methylprednisolone Injection for Sacroiliac Joint Pain

Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Intraarticular depo-steroid injection is a traditional approach to treating sacroiliac joint pain. For long-term pain relief, however, lesioning the sacral lateral branches may be a better approach. This study compared the efficacy of intraarticular depo-methylprednisolone injection to that of pulsed radiofrequency ablation for sacroiliac joint pain. This study used a randomized, prospective design. Thirty patients with diagnostic block-confirmed sacroiliac joint dysfunctional pain were randomly assigned to 2 groups. One group received intraarticular methylprednisolone and another group underwent pulsed radiofrequency of the L4 medial branch, the L5 dorsal rami, and the lateral sacral branches. Reduction in Numeric Rating Scale (NRS) for pain at 1 month post-procedure remained similar in Group A, while in Group B few patients reported a further decrease in the NRS score (3.333 ± 0.4880 and 2.933 ± 0.5936, respectively). At 3 months post-procedure, the NRS score began to rise in most patients in group A, while in Group B, the NRS score remained the same since the last visit (4.400 ± 0.9856 and 3.067 ± 0.8837, respectively). At 6 months post-procedure, the NRS score began to rise further in most patients in group A. In Group B, the NRS score remained the same in most of the patients since the last visit (5.400 ± 1.549 and 3.200 ± 1.207). There was a marked difference between the 2 groups in Oswestry Disability Index (ODI) scores at 3 months post-procedure (Group A, 12.133 ± 4.486 vs Group B, 9.133 ± 3.523) and at 6 months post-procedure there was a significant (P = 0.0017) difference in ODI scores between Group A and Group B (13.067 ± 4.284 and 8.000 ± 3.703, respectively). Global Perceived Effect (GPE) was assessed in both groups at 3 months post-procedure Only 33.3% (Confidence Interval (CI) of 11.8- 61.6 ) of patients in Group A had positive GPE responses whereas in Group B, 86.67% (CI of 59.5- 98.3 ) of patients had positive GPE responses. At 6 months post-procedure, the proportion of patients with positive GPE declined further in Group A, while in Group B, positive GPE responses remained the same (20% with a CI of 4.30- 48.10 and 86.67% with a CI of 59.5- 98.3, respectively ). Small sample size. This comparative study shows that pulsed radiofrequency denervation of the L4 and L5 primary dorsal rami and S1-3 lateral branches provide significant pain relief and functional improvement in patients with sacroiliac joint pain. Low back pain, sacroiliac joint dysfunctional pain, radiofrequency, intraarticular injection.

Randomised controlled trial comparing the intra-articular hyaluronic acid versus intra-articular steroid in osteoarthritis of knee

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Osteoarthritis of knee is a chronic degenerative joint disease which leads to pain, swelling and stiffness. Intra-articular hyaluronic acid or steroids are being used for its treatment. The purpose of the present study was to assess the effect of intra articular hyaluronic acid in comparison to steroids for knee osteoarthritis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective randomized study including 70 patients (121 knees) diagnosed with osteoarthritis of knee, were randomly divided into two groups: 35 patients (58 knees) were given intra-articular hyaluronic acid and 35 patients (63 knees) were given intra-articular methylprednisolone. The outcome was evaluated with knee society score (KSS) and visual analog scale (VAS) before the injection and 1, 3 and 6 months after the injection.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean KSS pain and function scores increased while VAS decreased in both the groups. All the scores showed improvement at 6 months follow up. In both the groups, the scores at 6 months were significantly better than the pre injection values, and the scores of hyaluronic acid group were significantly better compared to steroid group.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Intraarticular hyaluronic acid seems to be better for long term pain relief and preservation of function in comparison to intraarticular steroids in osteoarthritis of knee.