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The Effectiveness of Intraarticular Steroid Application in Patients With Degenerative Knee Osteoarthritis

Year 2013, Volume: 15 Issue: 2, 27 - 31, 01.07.2013

Abstract

Introduction: The effectiveness of intraarticular (IA) corticosteroid application for patientswith knee osteoarthritis (OA) is investigated by comparison of various pain and physical activityevaluation tests before and after treatment for a period of six months.Material and Methods: In a prospective, observational study, from 523 patients 496 of themwho were between ages of 40 to 75 years, ASA classification I to III completed the study afterEthical Committee approval. All patients received intraarticular injection of triamcinolone at adose of 40 mg. Investigated parameters besides clinical evaluation include; Visual analog scale(VAS) (0: no pain, 10: extreme pain), WOMAC (The Western Ontario and McmasterUniversities Osteoarthritis Index) scores for evaluation of pain intensity, WOMAC score andLaquesne indexes for evaluation of physical activity before and at 1 week, 1, 3 and 6 monthsafter treatment.Results: Pain VAS scores diminished significantly after treatment at first week, first month,third month and sixth month in comparison to before treatment (p

References

  • Kocaağa M. Total kalça ve diz artroplastilerinde TENS’ in farklı modalitelerinin rehabilitasyon üzerine etkileri ( yüksek lisans tezi) İstanbul: 1995.
  • Peyron JG. The epidemiyology of osteoartritis.In: Moskowitz RW, Howell DS, Goldberg VM, Mankin HJ, editors. Ch.1 in osteoarthritis, diagnosis and management. Philadelphia: W.B.Saunders; 1984.P.9-27.
  • Ersöz M, Ergün S. Diz osteoartritli olgularda diz eklem Kellgren- incelenmesi. Türk Fiz Tıp Rehab Derg 2001;82(2): 47: 5. Lawrence sistemiyle
  • Kutsal YG, Kara M. Diz osteoartriti. Sarıdoğan M (editör) Tanıdan Tedaviye Osteoartrit’ te. İstanbul: Nobel Tıp Kitabevi; 2007. S. 149-61.
  • Balch HW, Gibson JM, El- Ghobarey AF, Bain LS, Lynch MP. Repeated corticosteroid injections into knee joints. Rheumatol Rehabil 1977; 16(3): 137- 40.
  • Valtonen EJ. Clinical Comparison of triamcinolone hexacetonide and betamethasone in the treatment of osteoarthritis of the knee- joint. Scand J Rheumatol Suppl 1981; 41: 1- 7.
  • Recommendations fort he medical managment of osteoarthritis of the hip and knee: 2000 update, American Collage of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000; 43(9): 1905.
  • Gaffney K, Ledingham J, Perry JD. Intra-articular triamcinolone hexacetonide in knee osteoarthritis: factors influencing the clinical response. Ann Rheum Dis 1995; 54(5): 379–81.
  • Reuben SS, Sklar J. Pain management in patients who undergo outpatient arthroscopic surgery of the knee. J Bone Joint Surg Am 2000;82-A(12):1754–66.
  • Towheed TE, Hochberg MC. A systematic review of randomized, controlled trials of pharmacological therapy in osteoarthritis of the knee. Semin Arthritis Rheum 1997; 26:755–70.
  • Creamer P. Intra-articular corticosteroid treatment in osteoarthritis. Curr Opin Rheum 1999;11(1):417-21.
  • Romsing J, Moiniche S, Ostergaard D, Dahl JB. Local infiltration with NSAIDs for postoperative analgesia: evidence for a peripheral analgesic action. Acta Anesthesiol Scand 2000; 44(6): 672-83.
  • Raynauld JP, Buckland-Wright C, Ward R, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2003;48(2):370-7.
  • Önel D. Eklemlerin incelenmesi ve muayenesi. Romatizmal hastalıklar, muayene, teşhis, medical ve fizik tedaviler, İstanbul Nobel tıp Kitabevi, 1994; pp. 70- 164.
  • Myers SI. Supression of hyaluronic acid synthesis in synovial organ cultures by corticosteroid suspention. Arthritis Rheum. 1995; 28(12): 1275.
  • Eymontt MJ, Gordon GV, Schumacher HR. The effect of synovial permeability and synovial fluid leukocyte count in symptomatic osteoarthritis after intraarticular corticosteroid administration. J Rheumatol 1982; 9(2): 198.
  • Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis rheum 2000; 43(7): 1905- 15.
  • Jordan KM, Arden NK, Doherty M,et al. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis. Report of a Task Force of the Standing Committee for ınternational Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003;62(12): 1145- 55.
  • Beyazova M., Kutsal YG.: Fiziksel Tıp ve Rehabilitasyon, Güneş Kitabevi, İkinci Cilt. 2000 .
  • Bannuru R., Natov N., Obadan I., et al. Therapeutic Trajectory of Hyaluronic Acid versus Corticosteroids in the Treatment of Knee Osteoarthritis: A systematic Review and Meta- Analysis. Arthritis and Rheumatism(Arthritis Care and Research) 2009;61(12);pp.1704-11.
  • Dieppe PA, Sathapatayavongs B, Jones HE, Bacon PA, Ring EFJ. Intra-Articular Steroids in Osteoarthritis. Rheumatology 1980:19 (4); 212-17.
  • Uğur M., Tuğuç A., Melikoğlu M., Yıldırım K., Şenel K. Diz dejeneratif osteoartritli Hastalarda İntraartikuler Hyaluronik Asit ile İntraartikuler Prednizolon Asetatın Etkinliklerinin Karşılaştırılması. The Eurasian Journal of Medicine 2007:39(3);185-88.
  • Behrens F, Shepard N, Mitchell N. Alterations of rabbit articular cartilage by intra- articular injections of glucocorticoids. J Bone Joint Surg Am 1975; 57(1): 70- 6.
  • Papachristou G, Anagnostou S, Katsorhis T. The effect of intra- articular hydrocortisone injection on the articular cartilage of rabbits. Acta Orthop Scand 1997;57(1): 132- 4.
  • Raynould JP, Buckland-Wright C., Ward R,et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled Feb;48(2):370-7. Arthritis Rheum. 2003

Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği

Year 2013, Volume: 15 Issue: 2, 27 - 31, 01.07.2013

Abstract

Giriş: Diz osteoartritli (OA) hastalarda intraartiküler (İA) kortikosteroid uygulamasınınetkinliğininin araştırmasında değişik ağrı ve fiziksel aktivite değerlendirme testleri tedavidenönce ve tedaviden sonraki 6 aylık sürede değerlendirilerek karşılaştırıldı.Materyal ve Metod: Prospektif gözlemsel çalışmaya katılan 523 hastadan 40 ila 75 yaşaralığında ve ASA sınıflaması I ila III arasında olan 496’sı etik kurul onayı sonrası çalışmayıtamamladı. Tüm hastalara intraartiküler enjeksiyon triamsinolon 40 mg dozda uygulandı. Tedaviöncesi ve tedavi sonrası 1. hafta, 1.ay, 3.ay ve 6. ay klinik muayene yanı sıra ağrı duyusudeğerlendirmesinde vizüel analog skalası (VAS) (0: ağrı yok, 10: çok şiddetli ağrı) ile WOMAC(The Western Ontario and Mcmaster Universities Osteoarthritis Index) indeksleri ve fizikselaktivitenin incelenmesinde ise WOMAC ve Laquesne indeksleri kullanıldı.Bulgular: Tedavi sonrası 1.hafta, 1.ay, 3.ay, 6.ay ağrı VAS skorları tedavi öncesi VASskorlarından düşüktür ( p

References

  • Kocaağa M. Total kalça ve diz artroplastilerinde TENS’ in farklı modalitelerinin rehabilitasyon üzerine etkileri ( yüksek lisans tezi) İstanbul: 1995.
  • Peyron JG. The epidemiyology of osteoartritis.In: Moskowitz RW, Howell DS, Goldberg VM, Mankin HJ, editors. Ch.1 in osteoarthritis, diagnosis and management. Philadelphia: W.B.Saunders; 1984.P.9-27.
  • Ersöz M, Ergün S. Diz osteoartritli olgularda diz eklem Kellgren- incelenmesi. Türk Fiz Tıp Rehab Derg 2001;82(2): 47: 5. Lawrence sistemiyle
  • Kutsal YG, Kara M. Diz osteoartriti. Sarıdoğan M (editör) Tanıdan Tedaviye Osteoartrit’ te. İstanbul: Nobel Tıp Kitabevi; 2007. S. 149-61.
  • Balch HW, Gibson JM, El- Ghobarey AF, Bain LS, Lynch MP. Repeated corticosteroid injections into knee joints. Rheumatol Rehabil 1977; 16(3): 137- 40.
  • Valtonen EJ. Clinical Comparison of triamcinolone hexacetonide and betamethasone in the treatment of osteoarthritis of the knee- joint. Scand J Rheumatol Suppl 1981; 41: 1- 7.
  • Recommendations fort he medical managment of osteoarthritis of the hip and knee: 2000 update, American Collage of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000; 43(9): 1905.
  • Gaffney K, Ledingham J, Perry JD. Intra-articular triamcinolone hexacetonide in knee osteoarthritis: factors influencing the clinical response. Ann Rheum Dis 1995; 54(5): 379–81.
  • Reuben SS, Sklar J. Pain management in patients who undergo outpatient arthroscopic surgery of the knee. J Bone Joint Surg Am 2000;82-A(12):1754–66.
  • Towheed TE, Hochberg MC. A systematic review of randomized, controlled trials of pharmacological therapy in osteoarthritis of the knee. Semin Arthritis Rheum 1997; 26:755–70.
  • Creamer P. Intra-articular corticosteroid treatment in osteoarthritis. Curr Opin Rheum 1999;11(1):417-21.
  • Romsing J, Moiniche S, Ostergaard D, Dahl JB. Local infiltration with NSAIDs for postoperative analgesia: evidence for a peripheral analgesic action. Acta Anesthesiol Scand 2000; 44(6): 672-83.
  • Raynauld JP, Buckland-Wright C, Ward R, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2003;48(2):370-7.
  • Önel D. Eklemlerin incelenmesi ve muayenesi. Romatizmal hastalıklar, muayene, teşhis, medical ve fizik tedaviler, İstanbul Nobel tıp Kitabevi, 1994; pp. 70- 164.
  • Myers SI. Supression of hyaluronic acid synthesis in synovial organ cultures by corticosteroid suspention. Arthritis Rheum. 1995; 28(12): 1275.
  • Eymontt MJ, Gordon GV, Schumacher HR. The effect of synovial permeability and synovial fluid leukocyte count in symptomatic osteoarthritis after intraarticular corticosteroid administration. J Rheumatol 1982; 9(2): 198.
  • Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis rheum 2000; 43(7): 1905- 15.
  • Jordan KM, Arden NK, Doherty M,et al. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis. Report of a Task Force of the Standing Committee for ınternational Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003;62(12): 1145- 55.
  • Beyazova M., Kutsal YG.: Fiziksel Tıp ve Rehabilitasyon, Güneş Kitabevi, İkinci Cilt. 2000 .
  • Bannuru R., Natov N., Obadan I., et al. Therapeutic Trajectory of Hyaluronic Acid versus Corticosteroids in the Treatment of Knee Osteoarthritis: A systematic Review and Meta- Analysis. Arthritis and Rheumatism(Arthritis Care and Research) 2009;61(12);pp.1704-11.
  • Dieppe PA, Sathapatayavongs B, Jones HE, Bacon PA, Ring EFJ. Intra-Articular Steroids in Osteoarthritis. Rheumatology 1980:19 (4); 212-17.
  • Uğur M., Tuğuç A., Melikoğlu M., Yıldırım K., Şenel K. Diz dejeneratif osteoartritli Hastalarda İntraartikuler Hyaluronik Asit ile İntraartikuler Prednizolon Asetatın Etkinliklerinin Karşılaştırılması. The Eurasian Journal of Medicine 2007:39(3);185-88.
  • Behrens F, Shepard N, Mitchell N. Alterations of rabbit articular cartilage by intra- articular injections of glucocorticoids. J Bone Joint Surg Am 1975; 57(1): 70- 6.
  • Papachristou G, Anagnostou S, Katsorhis T. The effect of intra- articular hydrocortisone injection on the articular cartilage of rabbits. Acta Orthop Scand 1997;57(1): 132- 4.
  • Raynould JP, Buckland-Wright C., Ward R,et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled Feb;48(2):370-7. Arthritis Rheum. 2003
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Ayşe Baysal This is me

Mesut Erbaş This is me

Hüseyin Toman This is me

Emin Daldal This is me

Ömer F Şavluk This is me

Publication Date July 1, 2013
Published in Issue Year 2013 Volume: 15 Issue: 2

Cite

APA Baysal, A., Erbaş, M., Toman, H., Daldal, E., et al. (2013). Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği. Duzce Medical Journal, 15(2), 27-31.
AMA Baysal A, Erbaş M, Toman H, Daldal E, Şavluk ÖF. Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği. Duzce Med J. July 2013;15(2):27-31.
Chicago Baysal, Ayşe, Mesut Erbaş, Hüseyin Toman, Emin Daldal, and Ömer F Şavluk. “Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği”. Duzce Medical Journal 15, no. 2 (July 2013): 27-31.
EndNote Baysal A, Erbaş M, Toman H, Daldal E, Şavluk ÖF (July 1, 2013) Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği. Duzce Medical Journal 15 2 27–31.
IEEE A. Baysal, M. Erbaş, H. Toman, E. Daldal, and Ö. F. Şavluk, “Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği”, Duzce Med J, vol. 15, no. 2, pp. 27–31, 2013.
ISNAD Baysal, Ayşe et al. “Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği”. Duzce Medical Journal 15/2 (July 2013), 27-31.
JAMA Baysal A, Erbaş M, Toman H, Daldal E, Şavluk ÖF. Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği. Duzce Med J. 2013;15:27–31.
MLA Baysal, Ayşe et al. “Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği”. Duzce Medical Journal, vol. 15, no. 2, 2013, pp. 27-31.
Vancouver Baysal A, Erbaş M, Toman H, Daldal E, Şavluk ÖF. Dejeneratif Diz Osteoartriti (OA) Olan Hastalarda İntraartiküler Steroid Uygulamasının Etkinliği. Duzce Med J. 2013;15(2):27-31.