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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.
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.
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.
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.
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.
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.
Osteoarthritis Cartilage
The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review
P.S. McCabe et al.
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