Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty?
Abstract Background To study if pain relief after injection and arthroplasty correlate. Methods A retrospective cohort study included consecutive patients (n = 88; median age 64 (interquartile range (IQR) 22) years, 49 (56%) females) that received fluoroscopic-guided intra-articular hip injection wi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05969-4 |
| _version_ | 1797952733883400192 |
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| author | Thorsten Jentzsch Yann K. Meyer Ines Unterfrauner Andrea B. Rosskopf Christian W. Pfirrmann Patrick O. Zingg |
| author_facet | Thorsten Jentzsch Yann K. Meyer Ines Unterfrauner Andrea B. Rosskopf Christian W. Pfirrmann Patrick O. Zingg |
| author_sort | Thorsten Jentzsch |
| collection | DOAJ |
| description | Abstract Background To study if pain relief after injection and arthroplasty correlate. Methods A retrospective cohort study included consecutive patients (n = 88; median age 64 (interquartile range (IQR) 22) years, 49 (56%) females) that received fluoroscopic-guided intra-articular hip injection with contrast agent, anaesthetic (diagnostic), and corticosteroid (therapeutic) before implantation of primary total hip arthroplasty. Pain scores were assessed pre-injection, post-injection after 15 min (diagnostic phase) at first clinical follow up (therapeutic phase; median 2 (IQR 2) months), and postoperatively (last follow up (median 15 (IQR 5) months)). Responders had reduction in pain score ≥ 20 (numeric rating scale 0–100) points. The primary outcome was the same (or inverse) response to injection and arthroplasty. Results The median pain scores were higher pre-injection (68 (IQR 30) points) compared to the diagnostic phase (18 (IQR 40) points; p < 0.001), therapeutic phase (50 (IQR 40) points; p < 0.001), and post-operatively (2 (IQR 15) points; p < 0.001). On the one hand, 69 (78%) cases had the same response in the diagnostic phase and post-operatively (rho = 0.58; p < 0.001; sensitivity 83%); on the other hand 32 (36%) cases had the same response in the therapeutic phase and post-operatively (rho = 0.25; p < 0.001; sensitivity 33%). Furthermore, 57% and 91% of patients had an even better response post-operatively than in the diagnostic and therapeutic phases. Conclusions Pre-operative intraarticular injection can predict pain relief after primary total hip arthroplasty. A positive response to hip arthroplasty may be better predicted by the response to local anaesthetic (diagnostic phase) than corticosteroids. Most patients (91%) with osteoarthritis may expect better pain relief after arthroplasty compared to the therapeutic phase after injection. |
| first_indexed | 2024-04-10T22:50:55Z |
| format | Article |
| id | doaj.art-e3399e9558634bb0babafae9e135ed1a |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-10T22:50:55Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-e3399e9558634bb0babafae9e135ed1a2023-01-15T12:02:14ZengBMCBMC Musculoskeletal Disorders1471-24742023-01-012411610.1186/s12891-022-05969-4Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty?Thorsten Jentzsch0Yann K. Meyer1Ines Unterfrauner2Andrea B. Rosskopf3Christian W. Pfirrmann4Patrick O. Zingg5Department of Orthopaedics, Balgrist University Hospital, University of ZurichFaculty of Medicine, University of ZurichDepartment of Orthopaedics, Balgrist University Hospital, University of ZurichDepartment of Radiology, Balgrist University HospitalDepartment of Radiology, Balgrist University HospitalDepartment of Orthopaedics, Balgrist University Hospital, University of ZurichAbstract Background To study if pain relief after injection and arthroplasty correlate. Methods A retrospective cohort study included consecutive patients (n = 88; median age 64 (interquartile range (IQR) 22) years, 49 (56%) females) that received fluoroscopic-guided intra-articular hip injection with contrast agent, anaesthetic (diagnostic), and corticosteroid (therapeutic) before implantation of primary total hip arthroplasty. Pain scores were assessed pre-injection, post-injection after 15 min (diagnostic phase) at first clinical follow up (therapeutic phase; median 2 (IQR 2) months), and postoperatively (last follow up (median 15 (IQR 5) months)). Responders had reduction in pain score ≥ 20 (numeric rating scale 0–100) points. The primary outcome was the same (or inverse) response to injection and arthroplasty. Results The median pain scores were higher pre-injection (68 (IQR 30) points) compared to the diagnostic phase (18 (IQR 40) points; p < 0.001), therapeutic phase (50 (IQR 40) points; p < 0.001), and post-operatively (2 (IQR 15) points; p < 0.001). On the one hand, 69 (78%) cases had the same response in the diagnostic phase and post-operatively (rho = 0.58; p < 0.001; sensitivity 83%); on the other hand 32 (36%) cases had the same response in the therapeutic phase and post-operatively (rho = 0.25; p < 0.001; sensitivity 33%). Furthermore, 57% and 91% of patients had an even better response post-operatively than in the diagnostic and therapeutic phases. Conclusions Pre-operative intraarticular injection can predict pain relief after primary total hip arthroplasty. A positive response to hip arthroplasty may be better predicted by the response to local anaesthetic (diagnostic phase) than corticosteroids. Most patients (91%) with osteoarthritis may expect better pain relief after arthroplasty compared to the therapeutic phase after injection.https://doi.org/10.1186/s12891-022-05969-4PainInjectionSteroidsAnestheticsLocalHip |
| spellingShingle | Thorsten Jentzsch Yann K. Meyer Ines Unterfrauner Andrea B. Rosskopf Christian W. Pfirrmann Patrick O. Zingg Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty? BMC Musculoskeletal Disorders Pain Injection Steroids Anesthetics Local Hip |
| title | Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty? |
| title_full | Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty? |
| title_fullStr | Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty? |
| title_full_unstemmed | Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty? |
| title_short | Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty? |
| title_sort | can pre operative intraarticular injection predict pain relief after total hip arthroplasty |
| topic | Pain Injection Steroids Anesthetics Local Hip |
| url | https://doi.org/10.1186/s12891-022-05969-4 |
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