Fluoroscopy Aids Hip Injection
Researchers from the University of Alberta, Edmonton verified use of corticosteroids with fluoroscopy guidance for the treatment of osteoarthritis (OA) of the hip. The findings of the group’s clinical trial were published in Arthritis and Rheumatism.
The small study included 52 patients who all had symptomatic osteoarthritis. A double blind, randomized study compared intra-articular injection of bupivacaine and either triamcinolone or saline. Patients were seen for follow up at 1, 2, 3, and 6 months following injection.
The main outcome of interest was pain score, measured using the Western Ontario and McMaster Universities OA Index (WOMAC) assessment tool. Treatment response was defined by the group as a 20 percent decrease in the WOMAC score at two months after the baseline assessment completed before the injection. Other outcomes considered subscales on the WOMAC tool, quality of life assessment based on the SF-36, and patient’s overall assessment of health status.
For patients who received steroid treatment, the mean WOMAC score at two months after therapy decreased almost 50 percent (49.2%, dropping from 310.1 mm at baseline to 157.4 mm). Among the patients in the control group, the pain measure dropped by 2.5 percent; 314.3 to 306.5 mm. This difference between the two groups was highly statistically significant.
67.7 percent of the treatment group participants had a response to the intervention at two months, compared to 23.8 percent in the control group. This finding was also statistically significant. The response to treatment continued beyond the two month follow up visit, through three months after undergoing therapy.
Other findings revealed significant differences in the additional outcomes measured during the project. Those included a decrease in joint stiffness, as measured with the WOMAC scale, for the treatment group. Those patients also noted superior physical function, higher global health scores, and improved scores on the subscales of the SF-36.
Minimal adverse events were noted. The rate of such were essentially equivalent between the control and treatment groups.
The team concluded that fluoroscopy-guided corticosteroid injections of the hip offer improvements in pain and functioning for patients who have osteoarthritis of the hip. Those treatment advantages may provide patients with benefits up to three months. Future investigations suggested by the authors included evaluation of the frequency of interventions to treat this disease.
August 31, 2007 Related topics: Quality, Safety, Errors, Orthopedic