PURPOSE: We undertook a study to evaluate the effectiveness of corticosteroid injections in primary care patients with greater trochanteric pain syndrome (GTPS). METHODS: We evaluated the effect of corticosteroid injections compared with expectant treatment (usual care) in a pragmatic, multicenter, open-label, randomized clinical trial in the Netherlands. Patients (aged 18 to 80 years) with GTPS visiting 81 participating primary care physicians were randomly allocated to receive either local corticosteroid injections (n = 60) or usual care (n = 60). Primary outcomes of pain severity (numerical rating scale 0 to 10) and recovery (yes or no total or major recovery) were evaluated at 3-month and 12-month follow-up visits. Adverse events were collected at 6 weeks. RESULTS: At the 3-month follow-up visit, 34% of the patients in the usual care group had recovered compared with 55% in the injection group (adjusted OR = 2.38; 95% CI, 1.14-5.00, number needed to treat = 5). Pain severity at rest and on activity decreased in both groups, but the decrease was greater in the injection group, for an adjusted difference in pain at rest of 1.18 (95% CI, 0.31-2.05) and in pain with activity of 1.30 (95% CI, 0.32-2.29). At the 12-month follow-up, 60% of the patients in the usual care group had recovered compared with 61% in the injection group (OR = 1.05; 95% CI, 0.50-2.27). Pain severity at rest and on activity decreased in both groups and the 12-month follow-up showed no significant differences, with adjusted differences of 0.14 (95% CI, -0.75 to 1.04) for pain at rest and 0.45 (95% CI, -0.55 to 1.46) for pain with activity. Aside from a short period with superficial pain at the site of the injection, no differences in adverse events were found. CONCLUSION: In this first randomized controlled trial assessing the effectiveness of corticosteroid injections vs usual care in GTPS, a clinically relevant effect was shown at a 3-month follow-up visit for recovery and for pain at rest and with activity. At a 12-month follow-up visit, the differences in outcome were no longer present.
RCT Entities:
PURPOSE: We undertook a study to evaluate the effectiveness of corticosteroid injections in primary care patients with greater trochanteric pain syndrome (GTPS). METHODS: We evaluated the effect of corticosteroid injections compared with expectant treatment (usual care) in a pragmatic, multicenter, open-label, randomized clinical trial in the Netherlands. Patients (aged 18 to 80 years) with GTPS visiting 81 participating primary care physicians were randomly allocated to receive either local corticosteroid injections (n = 60) or usual care (n = 60). Primary outcomes of pain severity (numerical rating scale 0 to 10) and recovery (yes or no total or major recovery) were evaluated at 3-month and 12-month follow-up visits. Adverse events were collected at 6 weeks. RESULTS: At the 3-month follow-up visit, 34% of the patients in the usual care group had recovered compared with 55% in the injection group (adjusted OR = 2.38; 95% CI, 1.14-5.00, number needed to treat = 5). Pain severity at rest and on activity decreased in both groups, but the decrease was greater in the injection group, for an adjusted difference in pain at rest of 1.18 (95% CI, 0.31-2.05) and in pain with activity of 1.30 (95% CI, 0.32-2.29). At the 12-month follow-up, 60% of the patients in the usual care group had recovered compared with 61% in the injection group (OR = 1.05; 95% CI, 0.50-2.27). Pain severity at rest and on activity decreased in both groups and the 12-month follow-up showed no significant differences, with adjusted differences of 0.14 (95% CI, -0.75 to 1.04) for pain at rest and 0.45 (95% CI, -0.55 to 1.46) for pain with activity. Aside from a short period with superficial pain at the site of the injection, no differences in adverse events were found. CONCLUSION: In this first randomized controlled trial assessing the effectiveness of corticosteroid injections vs usual care in GTPS, a clinically relevant effect was shown at a 3-month follow-up visit for recovery and for pain at rest and with activity. At a 12-month follow-up visit, the differences in outcome were no longer present.
Authors: S M Bierma-Zeinstra; A M Bohnen; R M Bernsen; J Ridderikhoff; J A Verhaar; A Prins Journal: J Clin Epidemiol Date: 2001-11 Impact factor: 6.437
Authors: L D Roorda; C A Jones; M Waltz; G J Lankhorst; L M Bouter; J W van der Eijken; W J Willems; I C Heyligers; D C Voaklander; K D Kelly; M E Suarez-Almazor Journal: Ann Rheum Dis Date: 2004-01 Impact factor: 19.103
Authors: Aaltien Brinks; Bart W Koes; Aloysius C W Volkers; Jan A N Verhaar; Sita M A Bierma-Zeinstra Journal: BMC Musculoskelet Disord Date: 2010-09-13 Impact factor: 2.362
Authors: Antonio Frizziero; Filippo Vittadini; Andrea Pignataro; Giuseppe Gasparre; Carlo Biz; Pietro Ruggieri; Stefano Masiero Journal: Muscles Ligaments Tendons J Date: 2016-12-21
Authors: Neal L Millar; Karin G Silbernagel; Kristian Thorborg; Paul D Kirwan; Leesa M Galatz; Geoffrey D Abrams; George A C Murrell; Iain B McInnes; Scott A Rodeo Journal: Nat Rev Dis Primers Date: 2021-01-07 Impact factor: 52.329
Authors: Christoph A Agten; Andrea B Rosskopf; Patrick O Zingg; Cynthia K Peterson; Christian W A Pfirrmann Journal: Eur Radiol Date: 2014-10-03 Impact factor: 5.315
Authors: Alison Grimaldi; Rebecca Mellor; Paul Hodges; Kim Bennell; Henry Wajswelner; Bill Vicenzino Journal: Sports Med Date: 2015-08 Impact factor: 11.136
Authors: William G Mitchell; Sharon C Kettwich; Wilmer L Sibbitt; Randy R Sibbitt; Maheswari Muruganandam; Noelle A Rolle; William A Hayward; Roderick A Fields; Luis P Roldan; N Suzanne Emil; Monthida Fangtham; Arthur D Bankhurst Journal: Rheumatol Int Date: 2018-01-20 Impact factor: 2.631
Authors: Anjali Bhagra; Husnain Syed; Darcy A Reed; Thomas H Poterucha; Stephen S Cha; Tammy J Baumgartner; Paul Y Takahashi Journal: Int J Gen Med Date: 2013-04-15