Table 2.
Results of the included trials.
| Author/year | Pain outcome extracted | Hip pain | Side effects | Potential predictors | Conclusion | ||
|---|---|---|---|---|---|---|---|
| Baseline | Short term <8 weeks | Long term ≥8 weeks | |||||
| Atchia/2011 | NRS: worst pain# | Placebo: 6.55 ± 0.68 Steroid: 5.99 ± 0.62 |
1 week: placebo: 5.9 ± 0.96; steroid: 3.06 ± 1.2 (p < 0.001) 4 weeks: placebo: 6.42 ± 1.08; steroid: 3.89 ± 1.39 (p=0.01) |
8 weeks: placebo: 6.98 ± 0.89; steroid: 5.06 ± 1.23 (p=0.06) | NA | (1) Synovitis (2) Changes in medications |
(1) IAST is highly efficacious in pain relief (2) Synovitis is the single predictor in weeks 4 and 8 (3) No differences between NSAIDs and paracetamol or paracetamol/weak opioid groups during the trial |
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| Kullenberg/2004 | Total VAS | Placebo: NA Steroid: 12.2 ± 2.2 |
3 weeks: placebo: 12 ± 1; steroid: 3.8 ± 2.6 (p < 0.001) | 12 weeks: placebo: 12.4 ± 1.8; steroid: 7.9 ± 3.9 (p < 0.01) | NA | NA | IAST might improve pain and range of motion |
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| Lambert/2007 | WOMAC pain scores | Placebo: 314.3 ± 76.2 Steroid: 310.1 ± 54.6 |
1 month: placebo: 276.4 ± 129; steroid: 149.6 ± 113 (p=0.0005) | 2 months: placebo: 306.5 ± 121.2; steroid: 157.4 ± 127.2 (p < 0.0001) | One deep vein thrombosis at 3 months in the steroid group; one patient in the placebo group and 3 patients in the steroid group reported rebound pain | (1) Age (2) Severity of hip OA |
(1) IAST is an effective treatment in pain relief (2) The efficacy of IAST remained significant with age as a covariate (3) No association between the severity of OA and the responder status |
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| Qvistgaard/2006 | VAS (walking pain)# | Placebo: 42.4 ± 19.17 Steroid: 44.0 ± 19.17 |
2 weeks: placebo: 45.52 ± 19.17; steroid: 32.38 ± 19.17 (p=0.006) 4 weeks: placebo: 42.51 ± 19.17; steroid: 29.52 ± 19.17 (p=0.006) |
12 weeks: placebo: 38.32 ± 19.17; steroid: 35.85 ± 19.17 (p=0.58) | NA | (1) Degree of OA (2) Effusion in the joint (3) Age |
(1) IAST provided significant improvement in pain within 3 mo (2) Not related to the severity of OA, effusion in the joint, and age |
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| Micu/2010 | VAS (walking pain) | Control: 8.66 ± 0.79 Steroid: 8.17 ± 0.86 |
1 month: control: NA; steroid: 2.77 ± 0.79 (p < 0.001 vs. baseline) | 3 months: control: 7.02 ± 0.53; steroid: 3.66 ± 0.79 (p < 0.001 vs. baseline) | Transient facial rash was present in 16 patients during the first 24–48 h after injection | Severity of synovitis | (1) IAST is an efficacious and safe treatment in pain relief (2) Severity of synovitis was not significantly related to pain relief |
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| Flanagan/1988 | Grades 1–5 | NA | Positive responders: week 4: 9 | Positive responders: week 8: 4; week 24: 3; week 36: 2; week 48: 1 | NA | (1) Severity of OA (2) Time of the symptoms was present (3) Concentric type of arthritis |
(1) The patients had good pain relief within months but not longer than 1 year (2) Patients with severer symptoms had a longer response (3) Concentric type of arthritis does not respond to IAST |
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| Margules/2001 | NA | NA | NA | Pain relief responders: week 8: severe group: 9% (21/234); moderate group: 58% (131/226); mild group: 90% (46/51) | NA | Severity of OA | (1) IAST is an efficacious and safe treatment in pain relief (2) Patients with a slighter grade severity of OA had a higher positive responder rate on pain relief |
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| Deshmukh/2011 | VAS | Positive responders: 150 | Positive responders: 15–20 min: 148; week 2: 155 | NA | NA | (1) Severity of OA (2) Gender and age |
(1) Pain relief following IAST related to radiographic severity of OA (2) Neither gender nor age was a predictor |
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| Robinson/2007 | WOMAC pain scores | 40 mg: 12 (2–20) 80 mg: 12 (2–20) |
6 weeks: 40 mg: 10 (1–20) (p < 0.001); 80 mg: 8 (1–20) (p < 0.001) | 12 weeks: 40 mg: 12 (1–20) (p > 0.05); 80 mg: 10 (1–20) (p=0.002) | NA | (1) Dose (2) Stiffness at baseline (3) BMI (4) Severity of OA |
(1) The 80 mg dose had longer efficacy in week 12 (2) The responders had less stiffness at baseline (3) Not associated with BMI and severity of OA |
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| Subedi/2015 | OHS | NA | NA | Positive responders: 82 (all grades of osteoarthritis) | NA | Severity of OA | IAST is a highly effective therapeutic measure for hip osteoarthritis across all grades of disease severity |
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| Walter/2019 | EQ5D-VAS | 0 | <8 weeks: Δ in EQ5D-VAS: 1 ± 18.32 (p=0.915) | ≥8 weeks: Δ in EQ5D-VAS: 0.25 ± 20.58 (p=0.455) | NA | (1) Days from injection to surgery (2) Dose, sex, short/long-term follow-up, age, and BMI |
(1) No improvements in pain at short- and long-term intervals up to 6 months (2) Positive correlation with the number of days to surgery and patient-reported outcomes (3) Not related to dose, sex, age, and BMI |
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| Young/2012 | WOMAC pain scores | Low volume: 12.2 High volume: 12.3 |
NA | 3 months' Δ in pain: low volume: 8.8 (−28%); high volume: 8.9 (−28%) | One episode of temporary hyperglycaemia in a type 1 diabetic, one facial flush, one patient reported soft-tissue swelling, and two patients reported a temporary increase in pain | Injection volume | IAST is an effective therapeutic measure across volume of 3–12 ml |
NRS: numerical rating scale; NA: not available; IAST: intra-articular steroid therapy; NSAIDs: nonsteroid anti-inflammatory drugs; VAS: visual analog scale; OA: osteoarthritis; WOMAC: Western Ontario and McMaster Universities Arthritis Index; US: ultrasound; BMI: body mass index; EQ5D-VAS: EuroQol 5-domain visual analog scale; OHS: the Oxford hip score; Δ: change from baseline. #The pain score data were extracted from the accompany graph in the included studies.