The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg & Frederiksberg, Copenhagen, Denmark.
The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg & Frederiksberg, Copenhagen, Denmark; Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg & Frederiksberg, Copenhagen, Denmark.
Osteoarthritis Cartilage. 2016 May;24(5):814-21. doi: 10.1016/j.joca.2015.12.010. Epub 2015 Dec 31.
Knee osteoarthritis (KOA) is a multifactorial joint disease affecting many people worldwide. Recommended treatments for KOA include exercise and steroid injections, or a combination of these. The objective of this exploratory outcome analysis of a randomized trial was to assess changes in inflammation markers assessed by ultrasound imaging (US) in KOA secondary to intra-articular corticosteroid injection given prior to exercise therapy.
This study is a sub-study to a larger clinical trial which compared the clinical effects of steroid injection in KOA to placebo injection, both given prior to exercise therapy. The US outcomes were changes from baseline in US-assessed synovial size, Doppler activity presence in the synovial membrane, and numbers of US-detected Baker's cysts. US was performed at baseline, week 14 (exercise stop), and week 26 (follow-up).
Fifty participants received steroid injection, and 50 received placebo injection. All participants received 12 weeks of exercise. Forty-five and 44, respectively, completed the study. At week 14, the group difference in the change in synovium thickness was 2.2 mm (95%, confidence interval (CI) -0.5 to 4.8), P = 0.11. There were no group differences in the changes in distribution of patients with presence of synovial Doppler activity (P = 0.98) or Baker's cysts (P = 0.35). There were no statistically significant differences between groups at week 26 in any outcome.
Intra-articular steroid injection of KOA-patients prior to a 3 months exercise programme did not reduce synovial hypertrophy, synovial Doppler activity, or Baker's cyst presence more than a placebo saline injection according to US-assessments.
EudraCT: 2012-002607-18.
膝骨关节炎（KOA）是一种影响全球许多人的多因素关节疾病。KOA 的推荐治疗方法包括运动和皮质类固醇注射，或两者的结合。本项随机试验的探索性结局分析旨在评估在运动治疗前给予关节内皮质类固醇注射治疗后 KOA 的超声成像（US）评估的炎症标志物的变化。
本研究是一项对比较 KOA 皮质类固醇注射与安慰剂注射的大型临床试验的子研究，两种注射均在运动治疗前进行。US 结局是 US 评估的滑膜大小、滑膜膜中多普勒活动的存在以及 US 检测到的贝克氏囊肿数量的基线变化。US 在基线、第 14 周（运动停止）和第 26 周（随访）进行。
50 名参与者接受了皮质类固醇注射，50 名参与者接受了安慰剂注射。所有参与者均接受了 12 周的运动治疗。分别有 45 名和 44 名参与者完成了研究。在第 14 周，滑膜厚度变化的组间差异为 2.2 毫米（95%置信区间（CI）-0.5 至 4.8），P = 0.11。滑膜多普勒活动（P = 0.98）或贝克氏囊肿（P = 0.35）存在的患者分布变化两组间无差异。在第 26 周，任何结局两组间均无统计学差异。
在 3 个月运动方案之前，向 KOA 患者关节内注射皮质类固醇并不能减少滑膜肥大、滑膜多普勒活动或贝克氏囊肿的出现，与 US 评估相比，安慰剂盐水注射也没有更多的效果。
EudraCT：2012-002607-18。
