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Ultrasound guided intra-articular ketorolac versus corticosteroid injection in osteoarthritis of the hip: a retrospective comparative study

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Abstract

Objective

Intra-articular steroid injection has been widely used in the management of symptomatic osteoarthritis; however, its frequent use is avoided since there is an increase in the incidence of articular infection and several mechanical side effects such as cartilage breakdown and loss of elasticity of the articular cartilage. For these reasons, nonsteroidal anti-inflammatory drugs instead of corticosteroids can be considered for intra-articular injection. On this basis, we investigated the effects and safety of ultrasound-guided intra-articular ketorolac versus corticosteroid injection for patients with osteoarthritis of the hip.

Materials and methods

This retrospective study included 98 patients with diagnoses of hip osteoarthritis who underwent ultrasound-guided intra-articular ketorolac or corticosteroid injection. Fifty patients who received ultrasound-guided intra-articular corticosteroid injection were administered a mixture of 0.5 % lidocaine and triamcinolone. Forty-eight patients who received ultrasound-guided intra-articular ketorolac injection were administered 0.5 % lidocaine and ketorolac. Outcome measurement was assessed using the Harris hip score and verbal numeric pain scale, which were evaluated before the injections and at 1, 3 and 6 months following the injection. Univariate analysis (using the x 2 test) and multiple logistic regression analysis were performed to evaluate the relationship between the possible outcome predictors (injected medications, patients’ age, gender, pain duration and Kellgren-Lawrence classification) and the therapeutic effects.

Results

The Harris hip score and verbal numeric pain scale were improved at 1, 3 and 6 months after the injection in both groups. No statistical differences in the Harris hip score and verbal numeric pain scale were observed between the groups. The success rate was also not significantly different among the time periods of 1, 3 and 6 months. Multiple logistic regression and univariate analysis showed that injected medications patients’ age, gender, pain duration and Kellgren-Lawrence classification were not independent predictors of successful outcome at midterm follow-up.

Conclusion

The treatment of osteoarthritis of the hip with intra-articular ketorolac injection is as effective as that with intra-articular corticosteroid injection. Intra-articular ketorolac injection can be considered useful for patients with contraindications to using corticosteroids.

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Author notes

    Authors and Affiliations

    1. Department of Rehabilitation Medicine, Gachon University, Gil Medical Center, Incheon, South Korea

      Ki Deok Park

    2. Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul, South Korea

      Tai Kon Kim

    3. Institute of Rehabilitation Medicine, SRC Rehabilitation Hosipital, Gwangju, Gyeonggi-do, South Korea

      Byung Woo Bae

    4. Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea

      JaeKi Ahn & Yongbum Park

    5. Department of Anesthesiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea

      Woo Yong Lee

    6. Department of Physical Medicine & Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Sanggye 7 dong 761-7, Nowon-gu, 139-707, Seoul, South Korea

      Yongbum Park

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    1. Ki Deok Park
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    Correspondence to Yongbum Park.

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    Ki Deok Park and Tai Kon Kim contributed equally to this work.

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    Park, K.D., Kim, T.K., Bae, B.W. et al. Ultrasound guided intra-articular ketorolac versus corticosteroid injection in osteoarthritis of the hip: a retrospective comparative study. Skeletal Radiol 44, 1333–1340 (2015). https://doi.org/10.1007/s00256-015-2174-9

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