Intramuscular Corticosteroid Injection Reduces Hip Pain in OA

doctor giving injection to patient's knee
doctor giving injection to patient’s knee
In patients with osteoarthritis, corticosteroid injection was associated with significant hip pain reduction.

An intramuscular (IM) gluteal corticosteroid injection was effective in hip pain reduction compared with placebo injection in patients with hip osteoarthritis (OA) at 2-week follow-up, according to research presented at the 2017 Annual European Congress of Rheumatology (EULAR), held June 14-17, 2017 in Madrid, Spain.

In addition, the effect of the corticosteroid injection prolonged the entire 12-week follow-up period, researchers from Leids Universitair Medisch Centrum in Leiden, The Netherlands, said.

Since certain patients with hip OA were not responsive to oral analgesics, the researchers sought to assess the efficacy of an IM gluteal corticosteroid injection compared with placebo injection in reported hip pain severity in a randomized trial. They gave patients either 40 mg of triamcinolone acetate or saline (placebo) via an inferior alveolar (IA) nerve block injection into the ipsilateral gluteus muscle.

The primary outcome was severity of hip pain at 2 weeks, measured with a numerical rating scale (NRS) at rest and during walking (0-10; 0=no pain) and with the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) pain subscale (0-100; 0=no pain). “Secondary outcomes included hip pain severity (NRS, WOMAC pain, ICOAP [Intermittent and Constant Osteoarthritis Pain] score), function (WOMAC function), stiffness (WOMAC stiffness), adverse events, and medical co-interventions at 2, 4, 6, and 12 weeks follow-up,” according to the research team.

A total of 52 patients in the corticosteroid injection group and 54 in the placebo injection group were included in the analyses (68% female; mean age 64) OA duration was ≥1 year in 70% of patients. At 2 weeks follow-up, the corticosteroid injection was statistically significant and clinically relevant in hip pain reduction at rest (coefficient −1.3, 95% CI −2.3 to −0.3) compared with placebo.

“The corticosteroid injection was also associated with significant hip pain reduction at 4, 6, and 12 weeks,” the researchers said. “Moreover, at almost all follow-up measurements the estimates showed significant differences in favor of the corticosteroid injection on WOMAC pain, function, stiffness, total score, and ICOAP. No significant differences between groups were found for adverse events and medical co-interventions.”

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Dorleijn D, Luijsterburg P, Reijman M, et al. Intramuscular corticosteroid injection versus placebo injection in hip osteoarthritis: A 12-week blinded randomized controlled trial. Presented at: 2017 Annual European Congress of Rheumatology (EULAR); June 14-17, 2017; Madrid, Spain. doi:10.1136/annrheumdis-2017-eular.4767