Therapeutic Effects of Joint Lavage and Steroid Injection in Patients with Primary Osteoarthritis of the Knee

Abstract

Background: Osteoarthritis (OA) is one of the most common forms of articular disease and one of the major causes of pain and disability especially among the elderly. The purpose of this study was to assess the effect of lavage and interaarticular (IA) injection of corticosteroid in the knee joint for the treatment of OA compared to interaarticular injection of corticosteroid alone. Methods: This prospective clinical trial was done on 39 patients. In the first group (lavage plus interaarticular injection), 19 patients were enrolled and in the second group (interaarticular injection alone), 20 patients included. Initially the patients were classified with respect to their intensity of joint pain using a 100 mm visual analog scale (VAS), their global status (0-100) and Lequesne’s functional Index (0-25). These data were obtained at baseline, 4th week, 8th week and 12th week. Results: In the first group, the intensity of pain in 4th, 8th and 12th weeks became significantly attenuated in comparison with baseline value (P<0.001). Although in the second group its intensity in 4th week became attenuated compared to baseline value (P<0.001), its intensity did not decrease in 8th and 12th week significantly. There were significant changes regarding global status and Lequesne’s functional index till 12th week and in the second group till 4th week (P<0.001). Maximum amount of pain attenuation and improvement in global status and Lequesne’s functional index in the first group was observed in 12th week but responsiveness in the second group decreased significantly after 4th week. Conclusion: Joint lavage with or without steroid injection relieves pain and improves function, yet joint lavage and IA injection put a longer effect.
Keywords: Knee Osteoarthritis, Joint Lavage, Intraarticular Corticosteroid Injection