Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: a double-blind randomized clinical trial
| Autor: | Azadeh Jahangiri, Farid Rezaiee Moghaddam, Sharif Najafi |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual analogue scale medicine.medical_treatment Anti-Inflammatory Agents Osteoarthritis Placebo Methylprednisolone law.invention Injections Intra-Articular Cohort Studies Randomized controlled trial Double-Blind Method law Glucose Solution Hypertonic Carpometacarpal joint medicine Outpatient clinic Humans Orthopedics and Sports Medicine Anesthetics Local Aged Aged 80 and over Hand Strength business.industry Prolotherapy Lidocaine Carpometacarpal Joints Recovery of Function Methylprednisolone acetate Middle Aged medicine.disease Surgery Methylprednisolone Acetate medicine.anatomical_structure Treatment Outcome Anesthesia Female business |
| Zdroj: | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association. 19(5) |
| ISSN: | 1436-2023 |
| Popis: | To compare the advantages of prolotherapy in the treatment of first carpometacarpal osteoarthritis (OA) with those of corticosteroid local injection in the short and long term. We performed a randomized controlled trial from March 2010 to March 2011 in an outpatient clinic at a university hospital. Sixty participants (60 hands) with OA of the first carpometacarpal joint were assigned equally to two groups. For the corticosteroid group, after 2 monthly saline placebo injections, a single dose of 40 mg methylprednisolone acetate (0.5 ml) mixed with 0.5 ml of 2 % lidocaine was injected. For the dextrose (DX) group, 0.5 ml of 20 % DX was mixed with 0.5 ml of 2 % lidocaine and the injection was repeated monthly for 3 months. Pain intensity, hand function and the strength of lateral pinch grip were measured at the baseline and at 1, 2, and 6 months after the treatment. Mean age (STD) was 63.6 (9.7) years, and mean (STD) visual analog scale (VAS) was 6 (2). The two groups were comparable at 2 months, but significantly different at 1 month, with better results for corticosteroid, and at 6 months with apparently more favorable outcome for DX [mean difference (95 % CI) in VAS = 1.1 (0.2, 2.0), p = 0.02]. After 6 months of treatment, both DX and corticosteroid injection increased functional level, but DX seemed to be more effective [mean difference (95 % CI) in total function score = 1.0 (0.2, 1.8), p = 0.01]. For the long term, DX seems to be more advantageous, while the two treatments were comparable in the short term. Because of the satisfactory pain relief and restoring of function, we would prefer DX prolotherapy for the treatment of patients with OA. Therapeutic studies––investigating the results of treatment; level I. |
| Databáze: | OpenAIRE |
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