Effectiveness of intramuscular gluteal glucocorticoid injection versus intra-articular glucocorticoid injection in knee osteoarthritis

Autor: Marijn Vis, Patrick J E Bindels, Jacobijn Gussekloo, Desirée M. J. Dorleijn, Marianne F. Mol, Sita M A Bierma-Zeinstra, P. Koen Bos, Jos Runhaar
Přispěvatelé: General Practice, Orthopedics and Sports Medicine, Rheumatology, Faculteit Medische Wetenschappen/UMCG
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Triamcinolone acetonide
lcsh:Diseases of the musculoskeletal system
Time Factors
Knee Joint
PROGRESSION
Osteoarthritis
Q1
Severity of Illness Index
Triamcinolone Acetonide
law.invention
Injections
Intra-Articular
Non-inferiority
Study Protocol
0302 clinical medicine
Randomized controlled trial
law
Surveys and Questionnaires
Multicenter Studies as Topic
CRITERIA
SPACE
Orthopedics and Sports Medicine
BENEFIT
030212 general & internal medicine
Netherlands
Pain Measurement
Intramuscular
JOINT
R735
PAIN
Osteoarthritis
Knee
musculoskeletal system
Primary care
Treatment Outcome
Anesthesia
Knee osteoarthritis
medicine.symptom
Intramuscular injection
General practice
Glucocorticoid
medicine.drug
musculoskeletal diseases
medicine.medical_specialty
Injections
Intramuscular
03 medical and health sciences
Rheumatology
Double-Blind Method
Pragmatic Clinical Trials as Topic
medicine
INJURY
Glucocorticoid injection
Humans
Glucocorticoids
030203 arthritis & rheumatology
HIP
business.industry
medicine.disease
R1
CORTICOSTEROID INJECTIONS
Knee pain
Orthopedic surgery
lcsh:RC925-935
Intra-articular
business
BLOOD-GLUCOSE LEVELS
Zdroj: BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-9 (2020)
BMC Musculoskeletal Disorders, 21(1). BMC
BMC Musculoskeletal Disorders, 21(1):225. BioMed Central Ltd.
Bmc Musculoskeletal Disorders, 21(1):225. BioMed Central Ltd.
ISSN: 1471-2474
Popis: Background The knee is symptomatically the most frequent affected joint in osteoarthritis and, in the Netherlands and other Western countries, is mainly managed by general practitioners (GPs). An intra-articular glucocorticoid injection is recommended in (inter) national guidelines for patients with knee osteoarthritis as an option for a flare of knee pain and/or for those who are not responding well to pain medication. An innovative approach that could replace the intra-articular injection is an intramuscular gluteal glucocorticoid injection. An intramuscular injection is easier to perform than an intra-articular injection with lesser risk of severe local adverse reactions. We hypothesize that intramuscular gluteal glucocorticoid injection is non-inferior in reducing knee pain compared to intra-articular glucocorticoid injection, with potentially a longer lasting effect than intra-articular injection. Methods/design The study will be a pragmatic randomized controlled non-inferiority trial with two parallel groups. A total of 140 patients aged 45 years and older with knee osteoarthritis who contacted their general practitioner and have persistent knee pain (score ≥ 3 on 0–10 numerical rating scale; 0 = no knee pain) will be included. Patients will be randomly allocated (1:1) to an injection of 40 mg triamcinolone acetonide intra-articular in the knee joint or intramuscular in the ipsilateral ventrogluteal area. The effect of treatment will be evaluated by questionnaires at 2, 4, 8, 12, and 24 weeks after injection. The primary outcome is patients’ reported severity of knee pain measured with the pain subscale of the Knee injury and Osteoarthritis Outcome Score 4 weeks after injection. Statistical analysis will be based on both the per-protocol and the intention-to-treat principle. Discussion This study will evaluate non-inferiority of intramuscular glucocorticoid injection compared to intra-articular glucocorticoid injection for knee osteoarthritis symptoms. Trial registration This trial is registered in the Dutch Trial Registry (number NTR6968) at 2018-01-22 (https://www.trialregister.nl/trial/6784). Issue date: 1 October 2019. Trial sponsor Erasmus MC University Medical Center Rotterdam. PO-box 2040. 3000 CA Rotterdam. The Netherlands.
Databáze: OpenAIRE
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