Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain Sensitivity in Knee Osteoarthritis: Exploratory Outcome from a Randomized Controlled TrialReportar como inadecuado




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Objective

To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis OA.

Design

Randomized, masked, parallel, placebo-controlled trial involving 100 participants with clinical and radiographic knee OA that were randomized to one intra-articular injection on the knee with either 1 ml of 40 mg-ml methylprednisolone corticosteroid dissolved in 4 ml lidocaine 10 mg-ml or 1 ml isotonic saline placebo mixed with 4 ml lidocaine 10 mg-ml. Two weeks after the injections all participants undertook a 12-week supervised exercise program. Main outcomes were changes from baseline in pressure-pain sensitivity pressure-pain threshold PPT and temporal summation TS assessed using cuff pressure algometry on the calf. These were exploratory outcomes from a randomized controlled trial.

Results

A total of 100 patients were randomized to receive either corticosteroid n = 50 or placebo n = 50; 45 and 44, respectively, completed the trial. Four participants had missing values for PPT and one for TS at baseline; thus modified intention-to-treat populations were analyzed. The mean group difference in changes from baseline at week 14 was 0.6 kPa 95% CI: -1.7 to 2.8; P = 0.626 for PPT and 384 mm×sec 95% CI: -2980 to 3750; P = 0.821 for TS.

Conclusions

These results suggest that adding intra-articular corticosteroid injection 2 weeks prior to an exercise program does not provide additional benefits compared to placebo in reducing pain sensitivity in patients with knee OA.

Trial Registration

EU clinical trials EudraCT: 2012-002607-18



Autor: Alberto Soriano-Maldonado, Louise Klokker, Cecilie Bartholdy, Elisabeth Bandak, Karen Ellegaard, Henning Bliddal, Marius Henrikse

Fuente: http://plos.srce.hr/



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