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SAT0444 Comparasion of Efficacy of Intraarticuler Steroid Injections in The Patients with Knee Osteoarthritis with or without Synovitis
  1. E. Capkin1,
  2. O. Yerligök2,
  3. M. Karkucak2
  1. 1PM&R and Rheumatology
  2. 2Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey

Abstract

Background Osteoarthritis is a common joint disorder. In the knee, injections of corticosteroids into the joint may relieve inflammation, and reduce pain and disability

Objectives The present study aims to compare efficiency of intraarticular steroid injection administered on knee osteoarthritis (OA) patients between conditions whether synovitis exists, or not.

Methods The study included totally 90 patients (76 women and 14 men) who applied to the knee pain symptom and were diagnosed with knee OA. Based on the existence of synovitis determined clinically, patients were subclassified in 3 groups each consisted of 30 patients. Whereas the 1st group was including the patients with clinicaly synovitis; the 2nd group was including without synovitis. The 3rd group was considered as the control group with no synovitis. Each group was administered quadriceps strengthening exercises in addition to the prescription including 5% ibuprofen topical twice a day, and 75 mg diclofenac sodium taken orally twice a day. Group 1 and 2 patients were administered intraarticular steroid injection (20 mg Triamcinolone hexasetonit). Before the treatment, patients were evaluated in terms of Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) pain score, joint involvement score, physical function score and visual analog scale. In the post-injection period, patients invited for control at the 2nd and 8th weeks were evaluated based on the same parameters.

Results In all three treatment groups, a statistically significant recovery was observed in terms of pain, physical activity, and morning stiffness values at the end of both the 2nd and the 8th weeks compared to the initial period (p<0.05). The recovery in the injection groups was statistically more significant compared to the control group (p<0.001). There was no statistically significant all parameters difference between the synovitis OA and non-synovitis OA groups based on the controls at the 2nd and the 8th weeks (p>0.05)

Conclusions It was observed that intraarticular steroid injection reduced pain and stiffness related scores whether patients diagnosed with knee OA have synovitis, or not; and developed the functionality. However, these effects were observed only for limited period. Thus, concerning the patients who do not respond to medical treatment, intraarticular steroid injection can be considered as an effective treatment only for a short term.

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  2. Roemer FW, Guermazi A, Felson DT, Niu J, Nevitt MC, Crema MD, et al: Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study. Ann Rheum Dis 2011; 70: 1804–9.

  3. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al: American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012; 64: 465–74.

  4. Jones A, Doherty M: Intra-articular corticosteroids are effective inosteoarthritis but there are no clinical predictors of response. Annals of the Rheumatic Diseases 1996; 55: 829–32.

Disclosure of Interest None declared

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