EVALUATION OF THE EFFECT OF ADDING CORTICOSTEROID TO VISCOSUPPLEMENTATION: A PROSPECTIVE AND RANDOMIZED STUDY
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conferenceObject
Data de publicação
2012
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SPRINGER LONDON LTD
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Citação
OSTEOPOROSIS INTERNATIONAL, v.23, suppl.2, p.S132-S133, 2012
Resumo
Objective(s): The objective is to assess if we can improve the initial results of viscosupplementation by the addition of corticosteroids to the procedure, watching for any interference on the long-term results Material & Methods: We evaluated 104 patients with knee osteoarthritis (OA).All patients were receiving usual care, and those who underwent to intraarticular injection or knee surgery in the last 6 months, or had post-traumatic or rheumatoid arthritis were not included. We applied the visual analogic scale of pain (VAS) and WOMAC and Lequesne questionnaires. Patients were randomized into two groups of 52 patients each. Group 1 received a single intraarticular injection of theknee with 6 ml of Hylan GF-20 alone. Patients in group 2 received an intraarticular injection of the knee with 6 ml of Hylan GF-20 and 1 ml (20 mg) of hexacetonide triamcinolone. The questionnaires were applied prior to the injection (week zero) and at weeks 1, 4, 12 and 24 after the procedure. Results: The two groups were homogenous. Most patients were female (76%). The mean age was 62,7 years old. The average BMI of patients was 29.52. Most patients (34.6%) had a level 3 Kellgreen and Lawrence radiological classification for knee OA. At Week 1, Group 2 showed a marked reduction for WOMAC and VAS scores, with a statistically significant difference compared with Group 1 results. At week 4, group 2 still had better results for WOMAC and VAS compared to group 1, but with a p>0.05. The WOMAC and VAS results for weeks 12 and 24 were similar within the 2 groups. The Lequesne results had no statistically significant difference between the 2 groups at any moment. However, each group had a statistically significant improvement at weeks 1, 4, 12 and 24 compared to the baseline. None of the individuals characteristics such as age, genre, BMI or K&L classification had any effects on the results. Adverse effects: 4.8% presented effusion and 19.2% related discomfort or pain, with no statistic difference between groups. Conclusion(s): We concluded that the addition of 1 ml of triancinolone to viscosupplementation brings great improvement to its early results and does not affect the long-term results, so it should be performed.