Document Detail


A randomized placebo-controlled trial of arthroscopic lavage versus lavage plus intra-articular corticosteroids in the management of symptomatic osteoarthritis of the knee.
MedLine Citation:
PMID:  12867587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the efficacy of intra-articular steroid injections following arthroscopy and joint lavage in symptomatic OA of the knee. METHODS: Seventy-seven patients with OA of the knee were randomized to receive either 120 mg methylprednisolone acetate (MPA) or placebo following arthroscopy. Clinical assessments included severity of pain on movement and at rest, stiffness, the presence of joint effusions, range of movement, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score and Lequesne functional assessment. The outcome measures were evaluated at baseline and 2, 4, 8, 12 and 24 weeks. Further arthroscopies and synovial biopsies were performed at the time of clinical response and at relapse. RESULTS: An intention-to-treat analysis was performed on 71 patients (38 MPA, 33 placebo). Using the OARSI (Osteoarthritis Research Society International) response criteria, 58% of the steroid group vs 33% of the placebo group (adjusted relative risk = 2.38) (P = 0.004) responded at 4 weeks. At other time points, there were no significant differences between the treatment groups. There were no significant differences between the two treatment groups for pain, stiffness or WOMAC or Lequesne assessments at any time point. CONCLUSIONS: The response to intra-articular corticosteroids following joint lavage is short-lived (2-4 weeks), achievement of an OARSI response criterion being the only difference between the two groups.
Authors:
M D Smith; M Wetherall; T Darby; A Esterman; J Slavotinek; P Roberts-Thomson; M Coleman; M J Ahern
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2003-07-16
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  42     ISSN:  1462-0324     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-01-23     Revised Date:  2007-09-06    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1477-85     Citation Subset:  AIM; IM    
Affiliation:
Rheumatology Unit, Repatriation General Hospital, Daw Park, South Australia.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Aged
Arthroscopy* / adverse effects
Combined Modality Therapy
Female
Humans
Injections, Intra-Articular
Irrigation / methods
Male
Methylprednisolone / analogs & derivatives*,  therapeutic use*
Middle Aged
Osteoarthritis, Knee / drug therapy*,  surgery
Pain Measurement
Range of Motion, Articular
Recurrence
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 53-36-1/methylprednisolone acetate; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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