1 year ago
41
Osteoarthritis is simply a degenerative associated illness that causes the cartilage successful the joints to interruption down, starring to pain, stiffness, and trouble moving. It is simply a communal information that often affects the hands, knees, hips, and spine. Risk factors for processing osteoarthritis see aging, obesity, and a past of associated injuries.
Two caller studies person shown that corticosteroid injections, which are commonly utilized to dainty the symptom associated with genu osteoarthritis, whitethorn really lend to the progression of the disease. These findings were precocious presented astatine the yearly gathering of the Radiological Society of North America (RSNA).
Osteoarthritis is simply a wide information that affects 32.5 cardinal adults successful the United States and is characterized by the degeneration and breakdown of cartilage successful the joints. Knee osteoarthritis, which affects astir 800,000 radical each year, is simply a chronic and progressive information that tin origin symptom and trouble moving. Approximately 10% of individuals with genu osteoarthritis question noninvasive treatments and crook to corticosteroid oregon hyaluronic acid injections to alleviate their pain.
Researchers successful some studies chose cohorts from the Osteoarthritis Initiative, a multicenter, longitudinal, observational survey of astir 5,000 participants with genu osteoarthritis presently successful its 14th twelvemonth of follow-up.
Knee associated of a diligent showing (A) terrible cartilage defects and (B) intact genu joint. Credit: RSNA and Upasana Upadhyay Bharadwaj, M.D.
In the archetypal study, researchers astatine the University of California, San Francisco included 210 Osteoarthritis Initiative participants, 70 of whom received intraarticular injections, and a power radical of 140 who did not person injections during a two-year period. Of the 70 patients who received injections, 44 were injected with corticosteroids, and 26 were injected with hyaluronic acid. The attraction and power groups were matched by age, sex, assemblage wide index, symptom and carnal enactment scores, and severity of the disease.
MRI was performed connected each patients astatine the clip of the injection and 2 years earlier and after. The MRI scans were assessed utilizing whole-organ magnetic resonance imaging people (WORMS), a grading strategy for genu osteoarthritis that focuses connected the meniscus, bony marrow lesions, cartilage, associated effusion, and ligaments. The researchers identified osteoarthritis progression by comparing the imaging scores from the archetypal scans and two-year follow-up scans.
“This is the archetypal nonstop examination of corticosteroid and hyaluronic acerb injections utilizing the semi-quantitative, full organ appraisal of the genu with MRI,” said Upasana Upadhyay Bharadwaj, M.D., a probe chap successful the Department of Radiology astatine University of California, San Francisco.
Statistical investigation showed that corticosteroid genu injections were importantly associated with the wide progression of osteoarthritis successful the knee, specifically successful the lateral meniscus, lateral cartilage, and medial cartilage.
Hyaluronic acerb genu injections were not importantly associated with the progression of osteoarthritis successful the knee. Compared to the power group, the radical who received hyaluronic injections showed a decreased progression of osteoarthritis, specifically successful bony marrow lesions.
“While some corticosteroid and hyaluronic acerb injections are reported to assistance with symptomatic symptom alleviation for genu osteoarthritis, our results conclusively amusement that corticosteroids are associated with important progression of genu osteoarthritis up to 2 years post-injection and indispensable beryllium administered with caution,” Dr. Upadhyay Bharadwaj said.
“Hyaluronic acid, connected the different hand, whitethorn dilatory down the progression of genu osteoarthritis and alleviate semipermanent effects portion offering symptomatic relief.”
In the 2nd study, researchers astatine the Chicago Medical School of Rosalind Franklin University of Medicine and Science conducted a case-control survey comparing the radiographic progression of osteoarthritis successful patients who received injections of corticosteroids and hyaluronic acid.
“While these injections supply immoderate patients with short-term symptom relief, the effects of the injections connected the progression of the illness are unknown,” said researcher and aesculapian pupil Azad Darbandi.
Darbandi’s squad selected a cohort of 150 patients with akin baseline characteristics from the Osteoarthritis Initiative database, including 50 patients who received corticosteroid injections, 50 who received hyaluronic acerb injections, and 50 who were not injected implicit a 36-month clip period. The groups were matched by sex, assemblage wide index, and X-ray findings.
Patients underwent X-ray imaging of the genu astatine baseline and 2 years later. The researchers analyzed the X-ray imaging, including associated abstraction narrowing, enactment of bony spurs, and bony thickening astir the genu cartilage.
Compared to patients who received an injection of hyaluronic acerb oregon nary attraction astatine all, patients injected with corticosteroids had importantly much osteoarthritis progression, including medial associated abstraction narrowing, a hallmark of the disease.
“Even though imaging findings for each patients were akin astatine baseline, the imaging hallmarks of osteoarthritis were worse 2 years aboriginal successful patients who received corticosteroid injections compared to patients who received hyaluronic acerb injections oregon nary attraction astatine all,” Darbandi said.
“The results suggest that hyaluronic acerb injections should beryllium further explored for the absorption of genu osteoarthritis symptoms and that steroid injections should beryllium utilized with much caution.”
“Knowing the semipermanent effects of these injections volition assistance osteoarthritis patients and clinicians marque much informed decisions for managing the illness and the symptom it causes,” Dr. Upadhyay Bharadwaj added.
Meeting: 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America
Dr. Upadhyay Bharadwaj’s co-authors are Thomas Link, M.D., Ph.D., Zehra Akkaya, Gabby Joseph, John Lynch, Ph.D., and Paula Giesler. Darbandi’s co-authors are Sean Hormozian, Atefe Pooyan, M.D., Ehsan Alipour, M.D., Firoozeh Shomal Zadeh, M.D., Parham Pezeshk, M.D., and Majid Chalian, M.D.
English (US)