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[Short and long-term effectiveness of corticosterorid injections in osteoarticular pathology. Two-year Prospective
José Miguel Baena-Díez1, Meng Ting Sun-Ni2, Manel García-Lareo2
1Centro de Salud La Marina, Institut Català de la Salut, Barcelona, España; IDIAP Jordi Gol, Institut Català de la Salut, Barcelona, España.
Main Objective:
To evaluate the short- and long-term effectiveness and safety of corticosteroid injections.
Design:
Descriptive, prospective study.
Location:
Urban general practice centre.
Participants:
Adult patients (age>18 years) who experienced failure of medical treatment and reported pain scores ≥4 on the Visual Analogue Scale (VAS).
Interventions:
Patients received injections of triamcinolone acetonide, maximum 3injections.
Main Measurements:
Short-term success was defined as a reduction of ≥3 points on the VAS. Long-term success was defined as the absence of symptom recurrence at 6, 12, 18, and 24 months, with an assessment of any complications.
Results:
A total of 345 corticosteroid injections were administered. Patient's mean age was 58.8 years, and 73% were women. The most common conditions treated included rotator cuff disorders (38.3%), plantar fasciitis (16.5%), trochanteric bursitis (15.7%), epicondylitis (11.6%), and anserine bursitis (9.6%). 78.6% of injections were successful short term, with an average VAS reduction of 4.4 points (95% CI: 4.1-4.7). For the primary conditions, the VAS reduction exceeded 4 points. Long-term success rates were 73.3% at 6 months, 64.6% at 12 months, 60.6% at 18 months, and 56.5% at 24 months (P<0.001). At 24 months, the success rates were: rotator cuff disorders (49.2%), plantar fasciitis (49.1%), trochanteric bursitis (66.7%), epicondylitis (47.5%), and anserine bursitis (84.8%). The overall complication rate was 1.2%, all being minor.
Conclusions:
Corticosteroid injections are highly effective and safe for managing osteoarticular conditions short term. However, the effectiveness declines progressively over 2years, with outcomes varying depending on the specific pathology.
