Article

Osteoarthritis is one of the most frequent and chronic conditions that affect the
U.S. population. Use of intra-articular injections is one of the established
treatment options available in the nonoperative care for the management of
symptomatic osteoarthritis. Common injectable medications include
corticosteroids, hyaluronic acid, and other less traditional compounds (for
example, botulinum toxin). Corticosteroids work by anti-inflammatory and
antinociceptive actions. Corticosteroids have been shown to decrease pain and
symptoms associated with osteoarthritis for up to 3 weeks. Hyaluronic acid has an
unclear mechanism of action, but it is thought to promote the restoration of
hyaluronic acid within an osteoarthritic joint. The efficacy of hyaluronic acid
is modest and is most beneficial between 5 and 13 weeks after treatment. Other
injectable compounds have been studied and include botulinum toxin type A, which
has been theorized to work as an antinociceptive agent. One must be aware of the
potential adverse effects associated with these medications. For all of these
injectable treatments, the placebo effect must not be overlooked, because it has
be demonstrated in multiple studies that these medications provide similar relief
of pain when compared with placebo. Image guidance with ultrasound or fluoroscopy
may be considered when performing intra-articular injections to improve accurate
placement of medication.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS