I'm looking for several different studies and their results to see if there's any improvement in therapy. I want to know more about application in the knee joint.
Thank you!
The intraarticular application of corticosroids is an everyday practice in cases of gonarthritis, especially in patients with accompanying synovitis. You may look in textbooks of rheumatology or orthopaedics. The method is as old as 50-60 years and the results are good in the majority of selected cases. Unfortunately, there are adverse effects, one of which enhances the cartilage degeneration. So the corticosteroid application should be done with precautions.
In my opinion, it should be done in cases of a crisis of inflammation refractory to conservative measures. It should not be a routine procedure and only in some well chosen cases.
Yes,I agree with others.It is indicated in selective cases only,for example: Advanced case of osteoarthritis of knee wherein patient is not fit/willing for major surgical procedure,or patient on the waiting list for Knee replacement with exaggeration of pain.It should be done under aseptic precautions(preferably in the operation theatre) by a qualified Orthopaedic Surgeon.Not more than 4-5 injections should be administered at interval of 4-6 weeks,as it can cause crystal-induced synovitis & add to the problem of further damage to the joint.
Hello. I agree with the other comments. Don´t forget that there is a compuond of inflammatory substances in the synovial fuid in these articulations. The administration in these cases of corticosteroid injections and a previous drainage of the articulation can improve the pain in arthritic patients by the aintiinflammatory effect itself and lowering the intraarticular pressure.
We have seen quite a lot of not just simple inflammations, but real bacterial infections by this method. Either the doctor did not work fully under similar to OR-security or the patient was somehow immunsuppressed. As in those cases mostly a THP was necessary and because the helping success of all such injections last at most 3 months, I dont recommendate them. My microbiological collegue lars Frommelt (ENDO-Klinik Hamburg) may have a collection of such cases or can retrieve them by the Med.Doc and make a nice paper out of it.
True.As I had mentioned earlier,I am sceptical about this method of treating knee arthritis.In fact,Pharmaceutical companies are marketing Hyaluronic acid preparations(quite expensive) with better efficacy.One has to choose the patient carefully for such injections & perform it with due aseptic care !
My answer is the same as other consultants.
I only use the intra articular corticosteroid injection in severe inflamation cases.
In the case of simple arthritis i usually use hyaluronic acid preparatiion though it is expensive.
The intraarticular injections of corticosroids use are extremely rare. It may be used in chronic synovitis, rheumatoid arthritis. Frequent intra-articular use of corticosteroids leads to the degeneration of cartilage.
Agreed, a 'win-gain' scenario. Mr. Vukorepa here are a couple links for you to review.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095029/
http://www.ncbi.nlm.nih.gov/pubmed/12703656
Patients with arthrtis and synovitis, with effusion and hiperthermia, in whom you have discarded the possibility of joint infection, answer dramatically to intraarticular corticosteroid injection. It also may be combined to hyaluronic acid, accordingly to the paper below.
Adding Triamcinolone Improves Viscosupplementation:
A Randomized Clinical Trial. Clin Orthop Relat Res (2013) 471:613–620
There is a variety of visco supplement preparations now available in the market.One should know the right indications,cost factor ,frequency of injections & their limitations...
- Badges
- Science topic
- Similar topics
- Biological Science
- Molecular Biology
- Biomolecules
- Nucleic Acids
- DNA