Intraarticular Corticosteroid Injection: Pain Relief in Osteoarthritis of the Hip?

BJÖRN KULLENBERG, RONNY RUNESSON, RICHARD TUVHAG, CHRISTER OLSSON, and SYLVIA RESCH

ABSTRACT.

Objective. Osteoarthritis (OA) is one of the most common causes of morbidity in the elderly population, and surgery is often preceded by years of pain and disability. Intraarticular corticosteroid injections in osteoarthritic joints may play a role in the therapeutic plan and can afford quick pain relief but do not alter the underlying disease. There is a paucity of well controlled studies that provide recommendations for the use of corticosteroids in OA of the hip.

Methods. A prospective analysis of 80 patients with OA of the hip and pain at rest and on bearing weight for more than 4 weeks was performed. Patients were randomized into 2 groups; group 1 (n = 40) received corticosteroid (80 mg triamcinolone acetonide) and group 2 (n = 40) local anesthetic (1% mepivacaine), injected into the hip joint under fluoroscopy. Pain, functional ability, range of motion of the joint, and analgesics consumed were registered 3 weeks postinjection. The treatment was blind for the patients and the investigators performing the followup.

Results. Pain for all modalities decreased after corticosteroid injection, but pain at rest decreased the most. There was significant pain reduction at the 3 (and 12) week followup. Joint range of motion increased significantly for all directions. Functional ability improved significantly after injection. We found no significant pain relief or improvement of functional ability in patients treated with local anesthetics.

Conclusion. This study suggests that intraarticular corticosteroids might improve pain and range of motion of the affected joint in patients with hip OA. (J Rheumatol 2004;31:2265-8)

Key Indexing Terms:

CORTICOSTEROIDS
INJECTION
OSTEOARTHRITIS
HIP

From the Department of Orthopedics and Department of Rehabilitation, Blekinge Hospital, Karlshamn, Sweden.

B. Kullenberg, MD, Department of Orthopedics; R. Runesson, PT, Department of Rehabilitation; R. Tuvhag, RN; C. Olsson, MD; S. Resch, MD, PhD, Department of Orthopedics.

Address reprint requests to Dr. B. Kullenberg, Ort Klin, Blekingesjukhuset, Lansmansv 1, 374 80 Karlshamn, Sweden. E-mail: bjorn.kullenberg@ltblekinge.se

Submitted September 29, 2003; revision accepted May 28, 2004.

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