ISSN: 1134-8046
e-ISSN: 2254-6189

Indexada en:

Busqueda avanzada

Año 2021 / Volumen 28 / Suplemento 1

Abstract PDF HTML

Artículo Monográfico Osteoartritis

Infiltraciones de esteroides y ácido hialurónico en la artrosis
Infiltrations of steroids and hyaluronic acid in osteoarthritis

Rev. Soc. Esp. Dolor. 2021; 28(13): 64-72 / DOI: 10.20986/resed.2021.3854/2020

Félix Francisco

RESUMEN

Los esteroides intrarticulares (CS IA) se utilizan con frecuencia para el tratamiento del dolor de los pacientes con artrosis (OA) (tanto de rodilla como cadera), sobre todo en fases tempranas, con un comienzo de acción rápido proporcionando una mejoría a corto plazo (1-6 semanas). Los CS IA no mejoran clínica ni significativamente la función articular de rodillas o caderas (rigidez, distancia caminada ni movilidad articular) ni la calidad de vida. La eficacia de los CS IA en la OA de manos es menos evidente. El riesgo de efectos adversos precoces con el uso de CS IA es muy bajo. Sin embargo, los CS IA parece que producen efectos secundarios sobre el cartílago articular dependientes del tiempo y dosis. La tasa de infección después de una artroplastia de cadera no aumenta con las infiltraciones intrarticulares, siempre que pase suficiente tiempo entre la infiltración y la artroplastia (al menos 3-6 meses).
En pacientes con OA de rodilla, el ácido hialurónico intrarticular (AH IA) se ha mostrado eficaz en el control del dolor a medio plazo (5-13 semanas) que se puede mantener a largo plazo (26 semanas) con resultados funcionales menos evidentes. La eficacia del AH en el control del dolor y la funcionalidad en los pacientes con OA de cadera y manos es menos evidente. Los efectos secundarios del AH son locales, generalmente leves y transitorios. No está bien establecido si son más frecuentes con AH de alto peso molecular, AH de origen aviar o con repetidas inyecciones.
Las infiltraciones guiadas por imagen, en particular con ecografía, pueden mejorar la fiabilidad de la ubicación de la infiltración de CS o AH, sobre todo en cadera.

ABSTRACT

Intra-articular steroids (IA CS) are frequently used for the treatment of pain in patients with osteoarthritis (OA) of both the knee and the hip, especially in the early stages, with a rapid onset of action providing shortterm pain relief (1-6 weeks). IA CS do not clinically or significantly improve joint function of the knees or hips (stiffness, distance walked, or joint mobility) or quality of life. The efficacy of IA CS in hand OA is less evident. The risk of early adverse effects with the use of IA corticosteroids is very low. However, IA CS appear to have time- and dose-dependent side effects on articular cartilage. The infection rate after hip replacement does not increase with intra-articular injections, as long as there is enough time between the injection and the replacement (at least 3-6 months).
In patients with knee OA, intra-articular hyaluronic acid (IA HA) has been shown to be effective in controlling pain in the medium term (5-13 weeks) that can be maintained until the long term (26 weeks) with less obvious functional results. The efficacy of HA in pain control and functionality in patients with hip and hand OA is less evident. The side effects of HA are local, generally mild and transitory. It is not well established if they are more frequent with HA of high molecular weight, HA of avian origin or repeated injections.
Image-guided injections, particularly with ultrasound, can improve the reliability of the CS or HA injection location, especially in the hip.

Artículo Completo

Nuevo comentario

Código de seguridad:

Comentarios

No hay comentarios para este artículo.

Bibliografía

Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheum. 2020;72(2):220-33. DOI: 10.1002/acr.24131.

DOI: 10.1002/acr.24131

2. Rosseland LA, Helgesen KG, Breivik H, Stubhaug A. Moderate-to-severe pain after knee arthroscopy is relieved by intraarticular saline: a randomized controlled trial. Anesth Analg. 2004;98(6):1546-51. DOI: 10.1213/01.ane.0000112433.71197.fa.

DOI: 10.1213/01.ANE.0000112433.71197.FA

3. Abhishek A, Doherty M. Mechanisms of the placebo response in pain in osteoarthritis. Osteoarthritis Cartilage. 2013;21(9):1229-35. DOI: 10.1016/j.joca.2013.04.018.

DOI: 10.1016/j.joca.2013.04.018

4. Saltzman BM, Leroux T, Meyer MA, Basques BA, Chahal J, Bach BR, Jr., et al. The Therapeutic Effect of Intra-articular Normal Saline Injections for Knee Osteoarthritis: A Meta-analysis of Evidence Level 1 Studies. Am J Sports Med. 2017;45(11):2647-53. DOI: 10.1177/0363546516680607.

DOI: 10.1177/0363546516680607

5. Malemud CJ. Cytokines as therapeutic targets for osteoarthritis. BioDrugs. 2004;18(1):23-35. DOI: 10.2165/00063030-200418010-00003.

DOI: 10.2165/00063030-200418010-00003

6. Jüni P, Hari R, Rutjes AW, Fischer R, Silletta MG, Reichenbach S, et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst Rev. 2015;(10):CD005328. DOI: 10.1002/14651858.CD005328.pub3.

DOI: 10.1002/14651858.CD005328.pub3

7. Oo WM, Liu X, Hunter DJ. Pharmacodynamics, efficacy, safety and administration of intra-articular therapies for knee osteoarthritis. Expert Opin Drug Metab Toxicol. 2019;15(12):1021-32. DOI: 10.1080/17425255.2019.1691997.

DOI: 10.1080/17425255.2019.1691997

8. Saltychev M, Mattie R, McCormick Z, Laimi K. The Magnitude and Duration of the Effect of Intra-articular Corticosteroid Injections on Pain Severity in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Am J Phys Med Rehabil. 2020;99(7):617-25. DOI: 10.1097/PHM.0000000000001384.

DOI: 10.1097/PHM.0000000000001384

9. Zhong HM, Zhao GF, Lin T, Zhang XX, Li XY, Lin JF, et al. Intra-Articular Steroid Injection for Patients with Hip Osteoarthritis: A Systematic Review and Meta-Analysis. BioMed Res Int. 2020; 2020:6320154. DOI: 10.1155/2020/6320154.

DOI: 10.1155/2020/6320154

10. McCabe PS, Maricar N, Parkes MJ, Felson DT, O'Neill TW. The efficacy of intra-articular steroids in hip osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2016;24(9):1509-17. DOI: 10.1016/j.joca.2016.04.018.

DOI: 10.1016/j.joca.2016.04.018

11. Monseau AJ, Nizran PS. Common injections in musculoskeletal medicine. Prim Care. 2013;40(4):987-1000, ix-x. DOI: 10.1016/j.pop.2013.08.012.

DOI: 10.1016/j.pop.2013.08.012

12. Law TY, Nguyen C, Frank RM, Rosas S, McCormick F. Current concepts on the use of corticosteroid injections for knee osteoarthritis. Phys Sports Med. 2015;43(3):269-73. DOI: 10.1080/00913847.2015.1017440.

DOI: 10.1080/00913847.2015.1017440

13. Lazarevic MB, Skosey JL, Djordjevic-Denic G, Swedler WI, Zgradic I, Myones BL. Reduction of cortisol levels after single intra-articular and intramuscular steroid injection. Am J Med. 1995;99(4):370-3. DOI: 10.1016/s0002-9343(99)80183-1.

DOI: 10.1016/S0002-9343(99)80183-1

14. Habib GS. Systemic effects of intra-articular corticosteroids. Clin Rheumatol. 2009;28(7):749-56. DOI: 10.1007/s10067-009-1135-x.

DOI: 10.1007/s10067-009-1135-x

15. Cook CS, Smith PA. Clinical Update: Why PRP Should Be Your First Choice for Injection Therapy in Treating Osteoarthritis of the Knee. Curr Rev Musculoskelet Med. 2018;11(4):583-92. DOI: 10.1007/s12178-018-9524-x.

DOI: 10.1007/s12178-018-9524-x

16. Levy DM, Petersen KA, Scalley Vaught M, Christian DR, Cole BJ. Injections for Knee Osteoarthritis: Corticosteroids, Viscosupplementation, Platelet-Rich Plasma, and Autologous Stem Cells. Arthroscopy. 2018;34(5):1730-43. DOI: 10.1016/j.arthro.2018.02.022.

DOI: 10.1016/j.arthro.2018.02.022

17. McAlindon TE, LaValley MP, Harvey WF, Price LL, Driban JB, Zhang M, et al. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis a randomized clinical trial. JAMA. 2017;317(19):1967-75. DOI: 10.1001/jama.2017.5283.

DOI: 10.1001/jama.2017.5283

18. Zeng C, Lane NE, Hunter DJ, Wei J, Choi HK, McAlindon TE, et al. Intra-articular corticosteroids and the risk of knee osteoarthritis progression: results from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2019;27(6):855-62. DOI: 10.1016/j.joca.2019.01.007.

DOI: 10.1016/j.joca.2019.01.007

19. Wijn SRW, Rovers MM, Van Tienen TG, Hannink G. Intra-articular corticosteroid injections increase the risk of requiring knee arthroplasty a multicentre longitudinal observational study using data from the osteoarthritis initiative. Bone Joint J. 2020;102-B(5):586-92. DOI: 10.1302/0301-620X.102B5.BJJ-2019-1376.R1.

DOI: 10.1302/0301-620X.102B5.BJJ-2019-1376.R1

20. Raynauld JP, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2003;48(2):370-7. DOI: 10.1002/art.10777.

DOI: 10.1002/art.10777

21. Kompel AJ, Roemer FW, Murakami AM, Diaz LE, Crema MD, Guermazi A. Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps not as safe as we thought? Radiology. 2019;293(3):656-63. DOI: 10.1148/radiol.2019190341.

DOI: 10.1148/radiol.2019190341

22. Song YW, Zhang T, Wang WB. Gluococorticoid could influence extracellular matrix synthesis through Sox9 via p38 MAPK pathway. Rheumatol Int. 2012;32(11):3669-73. DOI: 10.1007/s00296-011-2091-8.

DOI: 10.1007/s00296-011-2091-8

23. Zuber TJ. Knee joint aspiration and injection. Am Fam Physician. 2002;66(8):1497-500, 503-4, 507.

24. Neustadt DH. Intra-articular injections for osteoarthritis of the knee. Cleve Clin J Med. 2006;73(10):897-8, 901-4, 6-11. DOI: 10.3949/ccjm.73.10.897.

DOI: 10.3949/ccjm.73.10.897

25. Lane NE, Thompson JM. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. Am J Med. 1997;103(6a):25s-30s. DOI: 10.1016/s0002-9343(97)90005-x.

DOI: 10.1016/S0002-9343(97)90005-X

26. Genovese MC. Joint and soft-tissue injection. A useful adjuvant to systemic and local treatment. Postgrad Med. 1998;103(2):125-34. DOI: 10.3810/pgm.1998.02.316.

DOI: 10.3810/pgm.1998.02.316

27. Ravi B, Escott BG, Wasserstein D, Croxford R, Hollands S, Paterson JM, et al. Intraarticular hip injection and early revision surgery following total hip arthroplasty: a retrospective cohort study. Arthritis Rheumatol. 2015;67(1):162-8. DOI: 10.1002/art.38886.

DOI: 10.1002/art.38886

28. Schairer WW, Nwachukwu BU, Mayman DJ, Lyman S, Jerabek SA. Preoperative Hip Injections Increase the Rate of Periprosthetic Infection After Total Hip Arthroplasty. J Arthroplasty. 2016;31(9 Suppl):166-9.e1. DOI: 10.1016/j.arth.2016.04.008.

DOI: 10.1016/j.arth.2016.04.008

29. Chambers AW, Lacy KW, Liow MHL, Manalo JPM, Freiberg AA, Kwon YM. Multiple Hip Intra-Articular Steroid Injections Increase Risk of Periprosthetic Joint Infection Compared With Single Injections. J Arthroplasty. 2017;32(6):1980-3. DOI: 10.1016/j.arth.2017.01.030.

DOI: 10.1016/j.arth.2017.01.030

30. Pereira LC, Kerr J, Jolles BM. Intra-articular steroid injection for osteoarthritis of the hip prior to total hip arthroplasty: Is it safe? A systematic review. Bone Joint J. 2016;98-B(8):1027-35. DOI: 10.1302/0301-620X.98B8.37420.

DOI: 10.1302/0301-620X.98B8.37420

31. Khanuja HS, Banerjee S, Sodhi GS, Mont MA. Do prior intra-articular corticosteroid injections or time of administration increase the risks of subsequent periprosthetic joint infections after total knee arthroplasty? J J Long Term Eff Med Implants. 2016;26(3):191-7. DOI: 10.1615/JLongTermEffMedImplants.2016014045.

DOI: 10.1615/JLongTermEffMedImplants.2016014045

32. Conduah AH, Baker CL, Baker CL. Managing joint pain in osteoarthritis: safety and efficacy of hylan G-F 20. J Pain Res. 2009;2:87-98. DOI: 10.2147/jpr.s4732.

DOI: 10.2147/JPR.S4732

33. Bert JM, Bert TM. Nonoperative treatment of unicompartmental arthritis: from bracing to injection. Clin Sports Med. 2014;33(1):1-10. DOI: 10.1016/j.csm.2013.08.002.

DOI: 10.1016/j.csm.2013.08.002

34. Reichenbach S, Blank S, Rutjes AW, Shang A, King EA, Dieppe PA, et al. Hylan versus hyaluronic acid for osteoarthritis of the knee: a systematic review and meta-analysis. Arthritis Rheum. 2007;57(8):1410-8. DOI: 10.1055/s-0038-1641142.

DOI: 10.1055/s-0038-1641142

35. Campbell KA, Erickson BJ, Saltzman BM, Mascarenhas R, Bach BR, Jr., Cole BJ, et al. Is Local Viscosupplementation Injection Clinically Superior to Other Therapies in the Treatment of Osteoarthritis of the Knee: A Systematic Review of Overlapping Meta-analyses. Arthroscopy. 2015;31(10):2036-45 e14. DOI: 10.1016/j.arthro.2015.03.030.

DOI: 10.1016/j.arthro.2015.03.030

36. Richette P, Chevalier X, Ea HK, Eymard F, Henrotin Y, Ornetti P, et al. Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias. RMD Open. 2015;1(1):e000071. DOI: 10.1136/rmdopen-2015-000071.

DOI: 10.1136/rmdopen-2015-000071

37. Bannuru RR, Natov NS, Dasi UR, Schmid CH, McAlindon TE. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis--meta-analysis. Osteoarthritis Cartilage. 2011;19(6):611-9. DOI: 10.1016/j.joca.2010.09.014.

DOI: 10.1016/j.joca.2010.09.014

38. Rodriguez-Merchan EC. Intra-articular Injections of Hyaluronic Acid and Other Drugs in the Knee Joint. HSS J. 2013;9(2):180-2. DOI: 10.1007/s11420-012-9320-x.

DOI: 10.1007/s11420-012-9320-x

39. Rutjes AW, Jüni P, da Costa BR, Trelle S, Nüesch E, Reichenbach S. Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. Ann Intern Med. 2012;157(3):180-91. DOI: 10.7326/0003-4819-157-3-201208070-00473.

DOI: 10.7326/0003-4819-157-3-201208070-00473

40. He WW, Kuang MJ, Zhao J, Sun L, Lu B, Wang Y, et al. Efficacy and safety of intraarticular hyaluronic acid and corticosteroid for knee osteoarthritis: A meta-analysis. Int J Surg. 2017;39:95-103. DOI: 10.1016/j.ijsu.2017.01.087.

DOI: 10.1016/j.ijsu.2017.01.087

41. Acuña AJ, Samuel LT, Jeong SH, Emara AK, Kamath AF. Viscosupplementation for hip osteoarthritis: Does systematic review of patient-reported outcome measures support use? J Orthop. 2020;21:137-49. DOI: 10.1016/j.jor.2020.03.016.

DOI: 10.1016/j.jor.2020.03.016

42. Leite VF, Daud Amadera JE, Buehler AM. Viscosupplementation for Hip Osteoarthritis: A Systematic Review and Meta-Analysis of the Efficacy on Pain and Disability, and the Occurrence of Adverse Events. Arch Phys Med Rehabil. 2018;99(3):574-83.e1. DOI: 10.1016/j.apmr.2017.07.010.

DOI: 10.1016/j.apmr.2017.07.010

43. Wu B, Li YM, Liu YC. Efficacy of intra-articular hyaluronic acid injections in hip osteoarthritis: A meta-analysis of randomized controlled trials. Oncotarget. 2017;8(49):86865-76. DOI: 10.18632/oncotarget.20995.

DOI: 10.18632/oncotarget.20995

44. Kroon FP, Rubio R, Schoones JW, Kloppenburg M. Intra-Articular Therapies in the Treatment of Hand Osteoarthritis: A Systematic Literature Review. Drugs Aging. 2016;33(2):119-33. DOI: 10.1007/s40266-015-0330-5.

DOI: 10.1007/s40266-015-0330-5

45. Trellu S, Dadoun S, Berenbaum F, Fautrel B, Gossec L. Intra-articular injections in thumb osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Joint Bone Spine. 2015;82(5):315-9. DOI: 10.1016/j.jbspin.2015.02.002.

DOI: 10.1016/j.jbspin.2015.02.002

46. Papalia R, Diaz LA, Torre G, Albo E, Tecame A, Sterzi S, et al. Intrarticular injections of hyaluronic acid for trapezio-metacarpal osteoarthritis: a systematic review. J Biol Regul Homeost Agents. 2017;31(4 Suppl 2):45-53.

47. Zhao H, Liu H, Liang X, Li Y, Wang J, Liu C. Hylan G-F 20 Versus Low Molecular Weight Hyaluronic Acids for Knee Osteoarthritis: A Meta-Analysis. BioDrugs. 2016;30(5):387-96. DOI: 10.1007/s40259-016-0186-1.

DOI: 10.1007/s40259-016-0186-1

48. Altman RD, Bedi A, Karlsson J, Sancheti P, Schemitsch E. Product Differences in Intra-articular Hyaluronic Acids for Osteoarthritis of the Knee. Am J Sports Med. 2016;44(8):2158-65. DOI: 10.1177/0363546515609599.

DOI: 10.1177/0363546515609599

49. Dai WL, Lin ZM, Guo DH, Shi ZJ, Wang J. Efficacy and Safety of Hylan versus Hyaluronic Acid in the Treatment of Knee Osteoarthritis. J Knee Surg. 2019;32(3):259-68. DOI: 10.1055/s-0038-1641142.

DOI: 10.1055/s-0038-1641142

50. Colen S, Van Den Bekerom MPJ, Mulier M, Haverkamp D. Hyaluronic acid in the treatment of knee osteoarthritis: A systematic review and meta-analysis with emphasis on the efficacy of different products. BioDrugs. 2012;26(4):257-68. DOI: 10.2165/11632580-000000000-00000.

DOI: 10.2165/11632580-000000000-00000

51. Mochizuki T, Ikari K, Yano K, Okazaki K. Comparison of patient-reported outcomes of treatment with low- and intermediate molecular weight hyaluronic acid in Japanese patients with symptomatic knee osteoarthritis: A prospective, randomized, single-blind trial. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2020;21:22-6. DOI: 10.1016/j.asmart.2020.04.001.

DOI: 10.1016/j.asmart.2020.04.001

52. Bahrami MH, Raeissadat SA, Cheraghi M, Rahimi-Dehgolan S, Ebrahimpour A. Efficacy of single high-molecular-weight versus triple low-molecular-weight hyaluronic acid intra-articular injection among knee osteoarthritis patients. BMC Musculoskelet Dis. 2020;21(1):550. DOI: 10.1016/j.asmart.2020.04.001.

DOI: 10.1016/j.asmart.2020.04.001

53. Maheu E, Avouac B, Dreiser RL, Bardin T. A single intra-articular injection of 2.0% non-chemically modified sodium hyaluronate vs 0.8% hylan G-F 20 in the treatment of symptomatic knee osteoarthritis: A 6-month, multicenter, randomized, controlled non-inferiority trial. PloS One. 2019;14(12):e0226007. DOI: 10.1371/journal.pone.0226007.

DOI: 10.1371/journal.pone.0226007

54. Ha CW, Park YB, Choi CH, Kyung HS, Lee JH, Yoo JD, et al. Efficacy and safety of single injection of cross-linked sodium hyaluronate vs. three injections of high molecular weight sodium hyaluronate for osteoarthritis of the knee: A double-blind, randomized, multi-center, non-inferiority study. BMC Musculoskelet Dis. 2017;18(1).

DOI: 10.1186/s12891-017-1591-4

55. Wang Y, Hall S, Hanna F, Wluka AE, Grant G, Marks P, et al. Effects of Hylan G-F 20 supplementation on cartilage preservation detected by magnetic resonance imaging in osteoarthritis of the knee: a two-year single-blind clinical trial. BMC Musculoskelet Dis. 2011;12:195. DOI: 10.1186/1471-2474-12-195.

DOI: 10.1186/1471-2474-12-195

56. Waddell DD, Joseph B. Delayed Total Knee Replacement with Hylan G-F 20. J Knee Surg. 2016;29(2):159-68. DOI: 10.1055/s-0034-1395281.

DOI: 10.1055/s-0034-1395281

57. Arrich J, Piribauer F, Mad P, Schmid D, Klaushofer K, Müllner M. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis. CMAJ. 2005;172(8):1039-43. DOI: 10.1503/cmaj.1041203.

DOI: 10.1503/cmaj.1041203

58. Petrella R, Anthony C, Decaria J. Comparison of avian and nonavian hyaluronic acid in OA of the knee. Orthop Res Rev. 2010;2:5-9.

59. Morton AH, Shannon P. Increased frequency of acute local reaction to intra-articular Hylan G-F 20 (Synvisc) in patients receiving more than one course of treatment. J Bone Joint Surg Am. 2003;85(10):2050; author reply 2050-1. DOI: 10.2106/00004623-200310000-00030.

DOI: 10.2106/00004623-200310000-00030

60. Leopold SS, Warme WJ, Pettis PD, Shott S. Increased frequency of acute local reaction to intra-articular hylan GF-20 (synvisc) in patients receiving more than one course of treatment. J Bone Joint Surg Am. 2002;84(9):1619-23. DOI: 10.2106/00004623-200209000-00015.

DOI: 10.2106/00004623-200209000-00015

61. Navarro-Sarabia F, Coronel P, Collantes E, Navarro FJ, de la Serna AR, Naranjo A, et al. A 40-month multicentre, randomised placebo-controlled study to assess the efficacy and carry-over effect of repeated intra-articular injections of hyaluronic acid in knee osteoarthritis: the AMELIA project. Ann Rheum Dis. 2011;70(11):1957-62. DOI: 10.1136/ard.2011.152017.

DOI: 10.1136/ard.2011.152017

62. Smith C, Patel R, Vannabouathong C, Sales B, Rabinovich A, McCormack R, et al. Combined intra-articular injection of corticosteroid and hyaluronic acid reduces pain compared to hyaluronic acid alone in the treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2019;27(6):1974-83. DOI: 10.1007/s00167-018-5071-7.

DOI: 10.1007/s00167-018-5071-7

63. Fatimah N, Salim B, Raja EUH, Nasim A. Predictors of response to intra-articular steroid injections in patients with osteoarthritis of the knee joint. Clin Rheumatol. 2016;35(10):2541-7. DOI: 10.1007/s10067-016-3365-z.

DOI: 10.1007/s10067-016-3365-z

64. Conrozier T, Eymard F, Chouk M, Chevalier X. Impact of obesity, structural severity and their combination on the efficacy of viscosupplementation in patients with knee osteoarthritis. BMC Musculoskelet Dis. 2019;20(1):376. DOI: 10.1186/s12891-019-2748-0.

DOI: 10.1186/s12891-019-2748-0

65. Maricar N, Parkes MJ, Callaghan MJ, Hutchinson CE, Gait AD, Hodgson R, et al. Structural predictors of response to intra-articular steroid injection in symptomatic knee osteoarthritis. Arthritis Res Ther. 2017;19(1):88. DOI: 10.1186/s13075-017-1292-2.

DOI: 10.1186/s13075-017-1292-2

66. Hoeber S, Aly AR, Ashworth N, Rajasekaran S. Ultrasound-guided hip joint injections are more accurate than landmark-guided injections: a systematic review and meta-analysis. Br J Sports Med. 2016;50(7):392-6. DOI: 10.1136/bjsports-2014-094570.

DOI: 10.1136/bjsports-2014-094570

67. Lundstrom ZT, Sytsma TT, Greenlund LS. Rethinking Viscosupplementation: Ultrasound- Versus Landmark-Guided Injection for Knee Osteoarthritis. J Ultrasound Med. 2020;39(1):113-7. DOI: 10.1002/jum.15081.

DOI: 10.1002/jum.15081

68. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-89. DOI: 10.1016/j.joca.2019.06.011.

DOI: 10.1016/j.joca.2019.06.011

69. Kloppenburg M, Kroon FP, Blanco FJ, Doherty M, Dziedzic KS, Greibrokk E, et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis. 2019;78(1):16-24. DOI: 10.1136/annrheumdis-2018-213826.

DOI: 10.1136/annrheumdis-2018-213826

Instrucciones para citar

Francisco F. Infiltraciones de esteroides y ácido hialurónico en la artrosis. Rev Soc Esp Dolor 2021; 28(13): 64-72 / DOI: 1020986/resed20213854/2020

Descargar a un gestores de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica

Este artículo ha sido visitado 29803 veces.
Este artículo ha sido descargado 174 veces.

Estadísticas de Dimensions

Estadísticas de Plum Analytics

Ficha Técnica

Aceptado: 18/01/2021

Publicado: 03/02/2021

Este artículo aun no tiene valoraciones.

Valoración del lector:

Valora este artículo:

Enviar por e-mail

Gestión de Cookies	Nombre	Tipo de Cookie	Función
Google	NID, PREF	Persistente	Personalizar los anuncios que se muestran en los servicios de Google.
Google Analytics	__utma, __utmb, __utmc, __utmz	Persistente	Conocer de forma anónima, nº de visitantes, procedencia, páginas visitadas, etc.