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  1. Professor Martin P Schwellnus
  1. University of Cape Town, South Africa

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Clinical effectiveness and dose response of image-guided intra-articular corticosteroid injection for hip osteoarthritis

Robinson P, Keenan AM, Conaghan PG. Rheumatology 2007;46:285–29

Background:

There are limited data on the effectiveness of differing doses of intra-articular corticosteroid injection on reducing pain, stiffness and disability in patients with hip osteoarthritis.

Research question/s:

Does either intra-articular steroid treatment (IAST) injection of either 40 or 80 mg improve pain, stiffness and disability over 12 weeks in patients with osteoarthritis of the hip?

Methodology:

Subjects: 120 patients with osteoarthritis of the hip (90 female 30 men; median age 64 years)

Experimental procedure: Subjects were referred for IAST (fluoroscopic guidance). All subjects underwent WOMAC scores, body mass index (BMI), conventional radiographic grade (Kellgren and Lawrence scoring) and ultrasound measures (including capsular thickness and osteophyte assessments) at baseline, 6 and 12 weeks. In phase 1 of the study, 75 patients were injected with 40 mg methylprednisolone (40 mg group), and then 45 patients were injected with 80 mg in phase 2 (80 mg group).

Measures of outcome: Changes in WOMAC scores (pain, disability, stiffness) from baseline to weeks 6 and 12, and imaging findings.

Main finding/s:

  • 12 weeks: There was a sustained reduced disability and improved stiffness in the 80 mg group at 12 weeks, but no difference between groups for pain (both …

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