P S McCabe1, N Maricar2, M J Parkes2, D T Felson3, T W O'Neill4. 1. Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK. Electronic address: paul.mccabe@manchester.ac.uk. 2. Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK. 3. Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK; Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA, USA. 4. Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.
Abstract
OBJECTIVE: International guidelines recommend intra-articular steroid injections (IASIs) in the management of hip osteoarthritis (OA), though these recommendations are extrapolated primarily from studies of knee OA. The aim of this systematic review was to assess the efficacy of IASI on pain in hip OA. METHODS: MEDLINE, EMBASE, AMED, CINAHL Plus, Web of Science and the Cochrane Central Register of Controlled Trials were searched to May 2015. Randomised controlled trials (RCTs) assessing the efficacy of hip IASI on pain were included. Pre-specified data was extracted using a standardised form. Quality was assessed using the Jadad score. RESULTS: Five trials met the inclusion criteria. All had a small number of participants (≤101). All studies reported some reduction in pain at 3-4 weeks post-injection compared to control. Based on data from individual trials the treatment effect size was large at 1 week post-injection but declined thereafter. A significant (moderate effect size) reduction in pain was reported in two trials up to 8 weeks following IASI. Pooled results of two trials (n = 90) showed an increased likelihood of meeting the Outcome measures in Rheumatology Clinical Trials (OMERACT)-Osteoarthritis Research Society International (OARSI) response criteria at 8 weeks post-IASI, odds ratio 7.8 (95% confidence interval (CI): 2.7-22.8). The number needed to treat to achieve one OMERACT-OARSI responder at 8 weeks post-injection was 2.4 (95% CI: 1.7-4.2). Hip IASI appear to be generally well tolerated. CONCLUSIONS: Hip IASI may be efficacious in short-term pain reduction in those with hip OA though the quality of the evidence was relatively poor. Further large, methodologically rigorous trials are required to verify whether intra-articular corticosteroids are beneficial and for how long.
OBJECTIVE: International guidelines recommend intra-articular steroid injections (IASIs) in the management of hip osteoarthritis (OA), though these recommendations are extrapolated primarily from studies of knee OA. The aim of this systematic review was to assess the efficacy of IASI on pain in hip OA. METHODS: MEDLINE, EMBASE, AMED, CINAHL Plus, Web of Science and the Cochrane Central Register of Controlled Trials were searched to May 2015. Randomised controlled trials (RCTs) assessing the efficacy of hip IASI on pain were included. Pre-specified data was extracted using a standardised form. Quality was assessed using the Jadad score. RESULTS: Five trials met the inclusion criteria. All had a small number of participants (≤101). All studies reported some reduction in pain at 3-4 weeks post-injection compared to control. Based on data from individual trials the treatment effect size was large at 1 week post-injection but declined thereafter. A significant (moderate effect size) reduction in pain was reported in two trials up to 8 weeks following IASI. Pooled results of two trials (n = 90) showed an increased likelihood of meeting the Outcome measures in Rheumatology Clinical Trials (OMERACT)-Osteoarthritis Research Society International (OARSI) response criteria at 8 weeks post-IASI, odds ratio 7.8 (95% confidence interval (CI): 2.7-22.8). The number needed to treat to achieve one OMERACT-OARSI responder at 8 weeks post-injection was 2.4 (95% CI: 1.7-4.2). Hip IASI appear to be generally well tolerated. CONCLUSIONS:Hip IASI may be efficacious in short-term pain reduction in those with hip OA though the quality of the evidence was relatively poor. Further large, methodologically rigorous trials are required to verify whether intra-articular corticosteroids are beneficial and for how long.
Authors: Michelle J Lespasio; Assem A Sultan; Nicolas S Piuzzi; Anton Khlopas; M Elaine Husni; George F Muschler; Michael A Mont Journal: Perm J Date: 2018
Authors: Antonio Barile; Alice La Marra; Francesco Arrigoni; Silvia Mariani; Luigi Zugaro; Alessandra Splendiani; Ernesto Di Cesare; Alfonso Reginelli; Marcello Zappia; Luca Brunese; Ejona Duka; Giampaolo Carrafiello; Carlo Masciocchi Journal: Br J Radiol Date: 2016-07-07 Impact factor: 3.039
Authors: Ali Guermazi; Tuhina Neogi; Jeffrey N Katz; C Kent Kwoh; Philip G Conaghan; David T Felson; Frank W Roemer Journal: Radiology Date: 2020-10-20 Impact factor: 11.105
Authors: Wilson C Lai; Armin Arshi; Dean Wang; Leanne L Seeger; Kambiz Motamedi; Benjamin D Levine; Sharon L Hame Journal: Skeletal Radiol Date: 2018-08-28 Impact factor: 2.199
Authors: Sebastián Cruz Rodriguez-García; Raul Castellanos-Moreira; Jacqueline Uson; Esperanza Naredo; Terence W O'Neill; Michael Doherty; Mikael Boesen; Hemant Pandit; Ingrid Möller Parera; Valentina Vardanyan; Lene Terslev; Will Uwe Kampen; Maria Antonieta D'Agostino; Francis Berenbaum; Elena Nikiphorou; Irene Pitsillidou; Jenny de la Torre-Aboki; Loreto Carmona Journal: RMD Open Date: 2021-06