The Predictors of Response to Intra-Articular Steroid Injections in Patients with Osteoarthritis of the Knee, in Jos University Teaching Hospital Jos Plateau State.

Abstract

Intra-articular injection of steroids is one of the armamentariums available for the clinical treatment of osteoarthritis. However, response to this modality varies in different patients, there is a need to determine which patients are likely to have a good response to IAIS. This is a randomized controlled trial study, patients with knee osteoarthritis who met the inclusion criteria where randomly divided into two groups. Baseline parameters were measured for each subject, before 40 mg methylprednisolone acetate mixed with 2 % lignocaine was injected into the knee either via the palpation technique or the ultrasound guided technique. VAS and WOMAC were calculated at 2 weeks, 4 weeks, and 3 months post IASI administration. Each participant was followed up for 3 months.

There was no significant difference between the sonography group and the conventional palpation technique group except in alcohol consumption with P values of 0.025 respectively. This study shows that intraarticular steroid injection is effective in reducing the WOMAC and VAS score by 50% in the first two weeks after the steroid injection in 78.4% using WOMAC and 100% using VAS score for the subjects in both groups. We found an association that could predict a 50% reduction in pain at 3 months. These variables are age, sex, alcohol, medial collateral ligament laxity, radiographic score, and range of motion. However, after running a logistic regression. none of the variables identified could predict the response at 3 months.