Corticosteroid/Ropivacaine Versus Corticosteroid/Saline Injections for Knee Osteoarthritis
| Status: | Recruiting |
|---|---|
| Conditions: | Arthritis, Osteoarthritis (OA) |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | October 2015 |
| End Date: | October 2016 |
Does Anesthetic Contribute to Symptomatic Relief in Corticosteroid Injections for Knee Osteoarthritis? A Double-Blind Randomized Trial Comparing Corticosteroid/Ropivacaine Versus Corticosteroid/Saline Injections
Corticosteroid injections are commonly used for the symptomatic treatment of knee
osteoarthritis. Common practice is to inject the joint with a combination of corticosteroid
and local anesthetic, with the rationale of providing longer duration pain relief with the
corticosteroid and immediate, though short duration relief with the anesthetic. However,
multiple in vitro and animal studies have shown that local anesthetic may be harmful to
chondrocytes. Despite this data, use of intra-articular anesthetic remains widespread. Many
clinicians believe incorporating the anesthetic is important because it can provide
immediate pain relief and facilitate patient confidence in the treatment program. However,
there is no published data to validate this reasoning. Therefore, the anesthetic has unknown
clinical benefit and may have adverse effects on articular cartilage. In light of this, the
investigators question the routine use of anesthetics in joint injections. The purpose of
this study is to compare the effects of knee joint injections using: 1) corticosteroid with
local anesthetic versus 2) corticosteroid with normal saline.
osteoarthritis. Common practice is to inject the joint with a combination of corticosteroid
and local anesthetic, with the rationale of providing longer duration pain relief with the
corticosteroid and immediate, though short duration relief with the anesthetic. However,
multiple in vitro and animal studies have shown that local anesthetic may be harmful to
chondrocytes. Despite this data, use of intra-articular anesthetic remains widespread. Many
clinicians believe incorporating the anesthetic is important because it can provide
immediate pain relief and facilitate patient confidence in the treatment program. However,
there is no published data to validate this reasoning. Therefore, the anesthetic has unknown
clinical benefit and may have adverse effects on articular cartilage. In light of this, the
investigators question the routine use of anesthetics in joint injections. The purpose of
this study is to compare the effects of knee joint injections using: 1) corticosteroid with
local anesthetic versus 2) corticosteroid with normal saline.
Inclusion criteria:
1. age 18 or older
2. knee osteoarthritis (uni- or bilateral) as defined by the American College of
Rheumatology (staged by Kellgren-Lawrence radiographic grading scale)
Exclusion criteria:
1. rheumatologic/inflammatory disease
2. metabolic bone disease
3. crystalline arthropathy
4. current smoking
5. BMI > 40
6. knee injection with corticosteroid or viscosupplementation within previous 6 months
7. history of knee prolotherapy, platelet rich plasma or cellular (stem cell) injection
8. knee surgery within the last year
9. chronic opioid use
10. chronic pain syndrome/fibromyalgia
11. pain behavior during the clinical encounter as judged by the injecting physician
12. physician specifically orders injection of corticosteroid/anesthetic or other
specific combined corticosteroid injection
13. diagnostic uncertainty by referring provider
14. referral for bilateral knee or multiple joint injections (*note that arthritis
involving multiple joints alone is not an exclusion criteria, only the patient
receiving more than 1 injection)
We found this trial at
1
site
200 First Street SW
Rochester, Minnesota 55905
Rochester, Minnesota 55905
507-284-2511
Phone: 507-284-2608
Mayo Clinic Rochester Mayo Clinic is a nonprofit worldwide leader in medical care, research and...
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