Ultrasonography Changes following Single Intra-articular Corticosteroid Injection in Knee Osteoarthritis- A Randomized Controlled Trial

Research Objectives: To measure severity of knee-pain following intra-articular corticosteroid (IA-CS) injection and to obseve Ultrasonography (USG) changes in the knee following injections.

Design: A randomized controlled trial

Setting: A tertiary care teaching hospital, India

Participants: Persons with Osteoarthritis (OA) knee with Kellgren Lawrence (KL) grade III and IV

Interventions: Forty persons with OA knee [KL grade III and IV] were randomized into two parallel groups (1:1). Persons allocated in Group I (n=20) received a 4ml of intra-articular corticosteroid (IA-CS) injection, and in Group II received 4ml 0.9% Normal Saline (NS) injection.

Main Outcome Measures: The pain intensity was measured with a visual analog scale (VAS) at baseline, 2 and 5 months. Knee changes were recorded with USG at baseline and at 5 months.

Results: The mean age and body mass index were 53.17±6.7 and 28.30±3.19 respectively. Baseline clinical and demographic parameters were comparable. The mean VAS score at 2 and 5 months after injection was 2.95±1.23 and 2.3±0.97 respectively in Group I and 5.65±1.2 and 5.3±1.3 respectively in Group II. At 5 months, there was a significant reduction in the number of persons with effusion in Group I (n=15, 67%, P< 0.05) as compared to Group II (n=8, 25%, P=0.5). However, there were no significant differences (P> 0.05) between the two groups in the number of persons with synovial hypertrophy, meniscal protrusion, and baker’s cyst at 5 months. There were no significant changes in mean cartilage thickness in either group.

Conclusions: Compared to NS injection, persons receiving IA-CS injection reported significant reduction in knee pain and less number of knee effusions.

Author(s) Disclosures: Nil