Ultrasound-guided intra-articular injection for hip OA reduced pain, improved outcomes
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Along with advice and education, a single ultrasound-guided intra-articular injection of triamcinolone and lidocaine improved outcomes and reduced pain in patients with hip osteoarthritis, according to published results.
In a single blind, parallel group, three arm trial, Zoe Paskins and colleagues analyzed 199 patients (mean age of 62.8 years) who presented with hip OA and pain of at least moderate intensity. Researchers randomly assigned 67 patients to receive the best current treatment (BCT), which is advice and education; 66 patients to receive the BCT plus ultrasound-guided injection of 40 mg triamcinolone acetonide and 4 mL 1% lidocaine hydrochloride; and 66 patients to receive the BCT plus ultrasound-guided injection of 5 mL 1% lidocaine. The main outcome measure was numerical rating scale (NRS) for hip pain. This was self-reported at 2 weeks, 2 months, 4 months and 6 months, according to the study.
At final follow-up, patients who received the BCT plus triamcinolone and lidocaine reported a greater mean improvement in NRS compared with patients who just received the BCT. Additionally, researchers found no difference in NRS between the BCT plus triamcinolone and lidocaine cohort and the BCT plus lidocaine cohort at 6 months.
Paskins and colleagues noted the presence of synovitis or effusion was associated with an interaction effect which favored the BCT plus triamcinolone and lidocaine cohort. One patient with a bioprosthetic aortic valve in the BCT plus triamcinolone and lidocaine cohort died 4 months after the intervention from subacute bacterial endocarditis, according to the study. Researchers deemed this “possibly related to the trial treatment,” they wrote in the study.
“These findings provide evidence to inform international guidelines and support treatment decision-making for policy makers, payers (commissioners), [general practitioners] GPs and clinicians in musculoskeletal services,” they added. “Our patient advisory group felt that these findings offer an important choice to patients, particularly those who are unsuitable for surgery and might feel their treatment options are limited.”
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