Table 1.
Intra-articular injections for the treatment of FAIS
| Author | Primary intervention | Comparator | Study design | N | Outcome measure | Follow-up (months) | Results | AEs | Conclusion |
|---|---|---|---|---|---|---|---|---|---|
| Abate et al. 2014 | 2 HA injections spaced out 40 days (0,6 mos) | None | Prospective cohort | 23 | Pain score, LISOH, mHHS, NSAID use | 6, 12 | Pain decreased at 6 and 12 months; LISOH decreased, mHHS improved at 12-month NSAID consumption reduced | Two local side effects | HA is safe and effective in the treatment of mild FAI, with significant pain reduction and functional improvement |
| Park et al. 2013 | IA triamcinolone | None | Case series | 3 | VAS, OHS | 0.5, 1, 2, 3 | OHS scores for all patients decreased at 3 months | None | IA steroid reduced the pain and improved function in 3 cases of FAI |
| Krych et al. 2014 | IA methyl-prednisolone acetate, triamcinolone, or betamethasone | None | Case series | 54 | NRS | 0.5, 1.5 | NRS decreased from post-injection anesthetic phase to 14 days. At 14 days, 20 patients, and at 6 weeks, 3 patients had clinically significant pain reduction | ND | Six percent of patients had sustained pain relief at 6 weeks. IA CSI has limited clinical benefit as a therapeutic modality |
| Lee et al. 2016 | HA injections (Hyruan plus Inj 2 ml/syringe) | IA CSI (triamcinolone) | Randomized crossover trial | 30 | NRS, HOOS, Oral medication | 3 | Seventeen patients w/o crossover, HOOS at 2 weeks improved w/ HA injection. Thirteen patients w/ crossover, NRS improved at 2 weeks w/ 1st TA injection w/o difference in HOOS. At 4 weeks, decrease of NRS was greater w/ 1st HA and 2nd TA injections; HOOS improved greater in 1st HA and 2nd TA injections | 8-facial flushing, menstrual irregularity, local site, effects | IA CSI had faster effect in pain relief. IA HA group had delayed effect in functional improvement |
| Pennock et al. 2018 | Initial trial of rest, PT, activity modification followed by IA triamcinolone, followed by arthroscopic surgery | None | Prospective cohort | 93 | Return to sport, mHHS, NAHS | 12,24 | Seventy percent responded to conservative measures 12% required CSI; 18% required surgery. All groups saw similar improvements in mHHS and NAHS. Cam and cam-pincer were 4 × more likely to require surgical intervention | ND | Eighty-two percent of adolescent patients with FAI can be managed non-operatively, with significant improvements in outcome scores at a mean follow-up of 2 years |
| Ebert et al. 2023 | IA triamcinolone w/ 12-week rehabilitation program | None | Case series | 44 | iHOT, HOS, mHHS, Tegner, VAS-S, ROM, Isometric strength | 4, 6, 12, 24 | 31.8% of patients progressed to surgical intervention over the 24-month post-injection period. In the non-operative cohort, a significant improvement in all patient-reported outcome measures were observed, with 93% satisfaction | None | Although 32% of patients progressed to surgery, significant improvement in hip pain, symptoms, and physical function was observed in patients because of a targeted non-operative management |
| Hunt et al. 2012 | Diagnostic IA triamcinolone + lidocaine | None | Prospective observational outcomes study | 52 |
NPRS, SF-12 mHHS, WOMAC NAHS, Baecke Questionnaire of Habitual Activity |
3, 12 | Twenty-three (44%) of patients reported satisfaction with conservative care. 56% chose to have surgery. Both groups demonstrated equally significant improvement in all outcome measures from baseline to 1 year | ND | A trial of conservative management for persons with prearthritic, intra-articular hip disorders should be considered before engaging in surgical intervention |
| De Luigi et al. 2019 | IA LR-PRP | None | Prospective cohort | 8 | VAS, HHS | 0.5, 1.5, 2 | Statistically significant improvements in VAS were seen with both rest and activity at 2 weeks, 6 weeks, and 8 weeks after PRP injection | None | Ultrasound-guided PRP injections hold promise as an emerging technique toward symptom relief, reducing pain, and improving function in patients with hip labral tears |
HA hyaluronic acid, mos months, IA intra-articular, mL milliliter, LR leukocyte rich, PRP platelet-rich plasma, CSI corticosteroid injection, LISOH Lequesne Index for Severity of Osteoarthritis of the Hip, mHHS modified Hip Harris Score, NSAID nonsteroidal anti-inflammatory, VAS Visual Analog Scale, OHS Oxford Hip Score, NRS Numerical Rating Scale, HOOS Hip Disabilities and Osteoarthritis Outcome Score, NAHS Non-arthritic Hip Score, iHOT International Hip Outcome Tool, HOS Hip Outcome Score, ROM range of motion, NPRS Numerical Pain Rating Scale, SF-12 12 Item Short Form Survey, WOMAC Western Ontario and McMaster Universities Osteoarthritis Index