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Randomized Controlled Trial
. 2022 Jul 26:77:100036.
doi: 10.1016/j.clinsp.2022.100036. eCollection 2022.

Intra-articular triamcinolone hexacetonide injections in hands osteoarthritis ‒ A double-blinded randomized controlled trial with a one year follow-up

Natalia de Oliva Spolidoro Paschoal  1 , Jamil Natour  1 , Flavia Soares Machado  1 , Hilda Alcântara Veiga de Oliveira  1 , Artur da Rocha Correa Fernandes  1 , Rita Nely Vilar Furtado  2
Affiliations
Randomized Controlled Trial

Intra-articular triamcinolone hexacetonide injections in hands osteoarthritis ‒ A double-blinded randomized controlled trial with a one year follow-up

Natalia de Oliva Spolidoro Paschoal et al. Clinics (Sao Paulo). .

Abstract

Objective: to evaluate the effectiveness of triamcinolone Hexacetonide (TH) Intra-Articular Injection (IAI) in hand Interphalangeal Joints (IP) of Osteoarthritis (OA) patients to improve pain and joint swelling; improve function, goniometry, and grasping force, and assess IAI influence on radiographic evolution over 1-year.

Methods: A randomized, double-blind study. 60 patients who underwent IAI at the most symptomatic IP joint were randomly assigned to receive TH+Lidocaine (LD) (TH/LD group) or just LD (LD group). Patients were assessed blindly for 1-year, at baseline and 1, 4, 8, 12, and 48 weeks. The following variables were assessed: articular pain and swelling, AUSCAN and COCHIN functional questionnaires, grip and pinch strength, goniometry, perception of improvement, acetaminophen consumption, and simple radiography. Repeated-measures ANOVA test was used to analyze the intervention response.

Results: Sixty patients completed the follow-up. There were nine missed assessments. 97% were women; mean age of 61-years (SD = 8.2), and approximately 5-years of disease (SD = 3.6). Half of the patients present radiographic classification Kellgren and Lawrence (KL) grades I and II, and the other half grades III and IV. The two groups evolved similarly at 48-weeks. TH/LD group had a better evaluation in joint swelling and acetaminophen consumption (p = 0.04 and p < 0.001, respectively) at 48-weeks. Radiographically there was no statistical difference between groups (KL, p = 0.564; erosive OA, p = 0.999; worsening, p = 0.573).

Conclusion: The IAI IP hands OA is effective for the improvement of joint swelling and decrease of analgesic consumption and does not influence the radiographic evolution of the injected joint.

Keywords: Corticosteroid; Hands; Intra-articular injection; Osteoarthritis.

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Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

Figures

Figure 1
Fig. 1
Study Flow Diagram. TH/LD, Triamcinolone Hexacetonide group; LD, Lidocaine group.
See this image and copyright information in PMC

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