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The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review

The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review
The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review

International guidelines recommend intra-articular steroid injections (IASIs) for the management of hip osteoarthritis (OA), though these recommendations are extrapolated primarily from studies of knee OA.

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Key take away

Short term pain reduction was observed in the hip osteoarthritis (OA) patients as depicted in this study. Further large scale evidences need to be employed to know the other aspects of these intra-articular steroid treatment. 

Background

International guidelines recommend intra-articular steroid injections (IASIs) for 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.

Method

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.

Result

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 1week 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.

Conclusion

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.

Source:

Osteoarthritis Cartilage

Article:

The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review

Authors:

P.S. McCabe et al.

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