Fowler A, Swindells M G, Burke F D
The Pulvertaft Hand Centre, Royal Derby Hospital, Uttoxeter Road, Derby, Derbyshire DE22 3NE UK.
Hand (N Y). 2015 Dec;10(4):583-92. doi: 10.1007/s11552-015-9778-3. Epub 2015 Jun 17.
Osteoarthritis of the trapeziometacarpal joint (TMJ) is a common condition causing significant disability. The aim of this study is to ascertain whether an intra-articular corticosteroid injection leads to pain relief and increased function and what is the duration and magnitude of this effect.
A systematic review with a critical appraisal of identified studies that met the inclusion criteria was performed. Two authors performed the literature review by independently searching the Cochrane, PubMed and Google Scholar databases.
A total of 118 relevant articles were found, but only nine studies met the inclusion criteria which included 4 double-blinded randomised control trials (RCTs) and 5 prospective case series. There is some evidence in the literature to support the efficacy of steroid injections into the TMJ. Most studies do suggest a good short-term benefit. However, one identifies no benefit over placebo but two studies found a benefit lasting at least 6 months.
This study demonstrates that there are potentially significant although short-term benefits to be gained from steroid injections into the TMJ. They can lead to pain relief and improved function, certainly in the first 1 to 3 months post-injection. Steroid injections are a low-risk procedure and are helpful in delaying or avoiding the need for surgery.
大多角掌骨关节（TMJ）骨关节炎是一种导致严重残疾的常见病症。本研究的目的是确定关节内注射皮质类固醇是否能缓解疼痛并改善功能，以及这种效果的持续时间和程度。
对符合纳入标准的已识别研究进行了系统评价和严格评估。两位作者通过独立检索Cochrane、PubMed和谷歌学术数据库进行文献综述。
共找到118篇相关文章，但只有9项研究符合纳入标准，其中包括4项双盲随机对照试验（RCT）和5项前瞻性病例系列研究。文献中有一些证据支持向TMJ注射类固醇的疗效。大多数研究确实表明有良好的短期益处。然而，有一项研究发现其效果并不优于安慰剂，但有两项研究发现其益处至少持续6个月。
本研究表明，向TMJ注射类固醇可能会带来潜在的显著短期益处。它们可以缓解疼痛并改善功能，在注射后的前1至3个月肯定如此。类固醇注射是一种低风险的操作，有助于延迟或避免手术需求。
