A randomised controlled trial of tidal irrigation vs corticosteroid injection in knee osteoarthritis: the KIVIS Study
Arden, N.K., Reading, I.C., Jordan, K.M., Thomas, L., Platten, H., Hassan, A. and Ledingham, J. (2008) A randomised controlled trial of tidal irrigation vs corticosteroid injection in knee osteoarthritis: the KIVIS Study. Osteoarthritis and Cartilage., 16, (6), 733-739. (doi:10.1016/j.joca.2007.10.011).
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Description/Abstract
OBJECTIVES: Patients with knee osteoarthritis (OA) often suffer pain that is not fully controlled by analgesics and often require intra-articular therapies. The aim of this study was to compare the benefits of intra-articular corticosteroid injections (CSIs) and tidal irrigation (TI) in patients with OA of the knee.
METHODS: We performed a dual-centre, single blind, randomised, parallel group trial comparing TI and CSI. Patients with knee OA were randomised to either irrigation using a 3.2mm arthroscope under local anaesthesia or an intra-articular injection of 40mg triamcinolone acetonide and 1% lidocaine. Patients were followed for 6 months. The primary outcome measure was the Western Ontario and McMaster Universities OA Index total pain score (visual analogue scale, VAS).
RESULTS: One hundred and fifty patients were recruited of whom 71 received TI and 79 CSI. In both treatment groups, over 80% of patients reported improvement at 2 and 4 weeks. After this time, the benefit of CSI decreased whereas that of TI was maintained: at 26 weeks the pain relief afforded by TI was significantly greater than that of CSI. At 26 weeks 29% of the CSI group reported improvement vs 64% of the TI group (P<0.001). Patients with a knee effusion responded better to both treatments, however, this was most apparent for CSI. Patients with less severe radiographic OA also obtained the greatest improvement from both treatments.
CONCLUSION: Both procedures lead to significant short-term pain relief of at least 4 weeks, however, TI displayed a significantly greater duration of benefit. Patients with effusions and milder radiographic change obtained the best response to treatment.
| Item Type: | Article |
|---|---|
| ISSNs: | 1063-4584 (print) |
| Related URLs: | |
| Keywords: | time, bone, injections, osteoarthritis, pain, therapy, methods |
| Divisions: | University Structure - Pre August 2011 > School of Medicine > Developmental Origins of Health and Disease University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences |
| Item ID: | 60873 |
| Date Deposited: | 09 Sep 2008 |
| Last Modified: | 02 Mar 2012 13:10 |
| Contributors: | Arden, N.K. (Author) Reading, I.C. (Author) Jordan, K.M. (Author) Thomas, L. (Author) Platten, H. (Author) Hassan, A. (Author) Ledingham, J. (Author) |
| Date: | 2008 |
| Status: | Published |
| URI: | http://eprints.soton.ac.uk/id/eprint/60873 |
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