Jones A, Doherty M
Rheumatology Unit, City Hospital, Hucknall Road, Nottingham, United Kingdom.
Ann Rheum Dis. 1996 Nov;55(11):829-32. doi: 10.1136/ard.55.11.829.
To show whether intra-articular steroid injections are effective in osteoarthritis; to determine factors that predict response; and to determine whether injection has a beneficial effect on muscle strength.
Double blind, placebo controlled, crossover study in 59 patients with symptomatic osteoarthritis of the knee. Outcome measure-Primary outcome measure: change in visual analogue score for pain at three weeks. Predictors of response analysed using logistic regression with a 15% decrease in pain score at three weeks defining response.
Intra-articular methyl prednisolone acetate produced a significant reduction in visual analogue pain score at three weeks compared to both baseline (median change -2.0 mm, interquartile range -16.25 to 4.0) and placebo (median 0.0 mm, interquartile range -9.0 to 6.25). No clinical predictors of response could be identified. Muscle strength was not significantly improved in the short term by intra-articular injection.
Intra-articular corticosteroids are effective for short term relief of pain in osteoarthritis but predicting responders is not possible. There may be a place for their more widespread use.
探讨关节内注射类固醇对骨关节炎是否有效；确定预测反应的因素；并确定注射对肌肉力量是否有有益影响。
对59例有症状的膝关节骨关节炎患者进行双盲、安慰剂对照、交叉研究。结果测量——主要结果测量：三周时疼痛视觉模拟评分的变化。使用逻辑回归分析反应的预测因素，以三周时疼痛评分降低15%定义为有反应。
与基线（中位数变化-2.0mm，四分位间距-16.25至4.0）和安慰剂（中位数0.0mm，四分位间距-9.0至6.25）相比，关节内注射醋酸甲泼尼龙在三周时显著降低了视觉模拟疼痛评分。无法确定反应的临床预测因素。关节内注射短期内未显著改善肌肉力量。
关节内注射皮质类固醇对骨关节炎的短期疼痛缓解有效，但无法预测哪些患者会有反应。它们可能有更广泛应用的空间。
