1 Hywel Dda NHS Trust, Swansea, United Kingdom.
Foot Ankle Int. 2018 Aug;39(8):1001-1004. doi: 10.1177/1071100718779983. Epub 2018 Jun 25.
Intra-articular corticosteroid injections are used for both their therapeutic and diagnostic function. There is a paucity of literature investigating the efficacy of intra-articular corticosteroid injections into the midfoot. The aim of the study was to identify the efficacy of image guided intra-articular corticosteroid (Methylprednisolone) injections for midfoot osteoarthritis The null hypothesis of this study was there would be no benefit or increase of the Self-reported Foot and Ankle Score (SEFAS) from an intra-articular corticosteroid injection.
SEFAS was collected at 4 and 12 months postinjection. A total of 37 consecutive patients who had 67 midfoot injections were recruited into the study over a 6-month period.
The mean SEFAS score preinjection was 17.0, at 4 months postinjection was 31.8 ( P < .001), and 12 months postinjection 21.3 ( P < .14). There was a statistically significant improvement in postinjection SEFAS ( P < .001) at 4 months. The null hypothesis of this study was rejected. Response to the injection was varied but patients with BMI less than 30 had a sustained ( P < .04) symptomatic improvement at 12 months when compared to the obese patients.
Our findings support the use of corticosteroid injections as a viable diagnostic and therapeutic option following failed conservative treatment options prior to operative intervention. The results at 4 months were statistically significant with an additional finding of a difference observed between obese and nonobese patients. This may have implications for further educating the patient in effective weight loss that may improve symptom relief from intra-articular injection.
Level III, comparative study.
关节内皮质类固醇注射因其治疗和诊断功能而被广泛应用。然而，目前关于关节内皮质类固醇注射治疗中足骨关节炎的疗效研究相对较少。本研究旨在探讨关节内皮质类固醇（甲泼尼龙）注射治疗中足骨关节炎的疗效。本研究的零假设为，关节内皮质类固醇注射不会改善或增加自我报告的足部和踝关节评分（SEFAS）。
在注射后 4 个月和 12 个月时收集 SEFAS。在 6 个月的时间内，共招募了 37 名连续患者，他们接受了 67 次中足注射。
注射前 SEFAS 平均评分为 17.0，注射后 4 个月为 31.8（P<.001），12 个月为 21.3（P<.14）。注射后 SEFAS 有显著改善（P<.001）。本研究的零假设被拒绝。注射的反应各不相同，但与肥胖患者相比，BMI 小于 30 的患者在 12 个月时具有持续的（P<.04）症状改善。
我们的研究结果支持在手术干预之前，将皮质类固醇注射作为一种可行的诊断和治疗选择，用于失败的保守治疗方案。4 个月时的结果具有统计学意义，并且观察到肥胖患者和非肥胖患者之间存在差异。这可能意味着需要进一步向患者进行有效的减肥教育，这可能会改善关节内注射的症状缓解。
III 级，比较研究。
