Comparisons of Intra-articular Knee Steroid Injection with and without Xylocaine in Patients with Symptomatic Knee Osteoarthritis without Effusion: A Retrospective Study

Abstract

Background: Intraarticular knele injection with steroid is an intervention for patients with severe osteoarthritis (OA) knee. Xylocaine, in some cases is mixed with steroid aiming to reduce immediate pain from the injection. However, xylocaine might relate with cartilage erosion. Objective: This study aims to compare immediate visual analog score (VAS) pain score in patients with severe OA knees who received steroid intraarticular injection with and without xylocaine. Method: This retrospective study reviewed patients with severe primary osteoarthritis knee without effusion diagnosed with clinical presentation and radiography. Two groups of patients, received steroid with and without xylocaine intraarticular injection, were compared using VAS to measure immediate pain intensity after the injection. Postprocedural range of motion (ROM) and complications were also reviewed. Result: Of 118 participants, 59 patients received steroid with xylocaine and 59 patients received steroid without xylocaine intraarticular injection. Radiographic data and baseline clinical presentation of both groups were comparable. Intraarticular knee injection by steroid with xylocaine and without xylocaine significantly reduced post procedural VAS but were not significantly clinical different between two groups (6.68±1.39 VS 6.14±1.48; p = .043). Range of motion (ROM) after injection were significantly increased in both groups, but were not significantly different between two groups. No major complications were recorded. Conclusion: Intraarticular knee injection with steroid and xylocaine did not significantly clinical reduced postprocedural pain score and ROM, compared to injection without xylocaine. Long-term complications and placebo effect needed to be further investigated.