Evidence map›Paper›PMID 36624434›Full record

ArticleBMC musculoskeletal disorders2023

Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty?

Thorsten Jentzsch, Yann K Meyer, Ines Unterfrauner, Andrea B Rosskopf, Christian W Pfirrmann, Patrick O Zingg

Abstract read
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Article in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Thorsten JentzschDepartment of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland. thorsten.jentzsch@balgrist.ch.
Yann K MeyerFaculty of Medicine, University of Zurich, Zurich, Switzerland.
Ines UnterfraunerDepartment of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Andrea B RosskopfDepartment of Radiology, Balgrist University Hospital, Zurich, Switzerland.
Christian W PfirrmannDepartment of Radiology, Balgrist University Hospital, Zurich, Switzerland.
Patrick O ZinggDepartment of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo study if pain relief after injection and arthroplasty correlate.

methodsA 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.

resultsThe 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.

conclusionsPre-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.

Indexed as

Arthroplasty, Replacement, HipAdultFemaleHumansInjections, Intra-ArticularMalePainRetrospective StudiesTreatment OutcomeYoung AdultAnestheticsArthroplastyHipInjectionLocalPainSteroids

Identifiers

PMID36624434
PMCPMC9827715

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