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Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines

Osteoarthritis (OA) is a leading cause of disability among older adults. Numerous pharmaceutical and nonpharmaceutical interventions have been described. Intra-articular injections are commonly the first line treatment. There are several articles, reporting the outcome of corticosteroids (CS), hyalu...

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Autores principales: Pavone, Vito, Vescio, Andrea, Turchetta, Matteo, Giardina, Serena Maria Chiara, Culmone, Annalisa, Testa, Gianluca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8096293/
https://www.ncbi.nlm.nih.gov/pubmed/33959026
http://dx.doi.org/10.3389/fphar.2021.661805
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author Pavone, Vito
Vescio, Andrea
Turchetta, Matteo
Giardina, Serena Maria Chiara
Culmone, Annalisa
Testa, Gianluca
author_facet Pavone, Vito
Vescio, Andrea
Turchetta, Matteo
Giardina, Serena Maria Chiara
Culmone, Annalisa
Testa, Gianluca
author_sort Pavone, Vito
collection PubMed
description Osteoarthritis (OA) is a leading cause of disability among older adults. Numerous pharmaceutical and nonpharmaceutical interventions have been described. Intra-articular injections are commonly the first line treatment. There are several articles, reporting the outcome of corticosteroids (CS), hyaluronic acid (HA) and platelet rich plasma (PRP). The aim of the study is to highlight the usefulness, indication and efficacy of the intra-articular injection of principal drugs. CSs have been shown to reduce the severity of pain, but care should be taken with repeated injections because of potential harm. HA reported good outcomes both for pain reduction and functional improvement. Different national societies guidelines do not recommend the PRP intra-articular injection in the management of knee OA for lack of evidence. In conclusion, the authors affirm that there is some evidence that intra-articular steroids are efficacious, but their benefit may be relatively short lived (<4 weeks). Most of the positive outcome were limited to the studies or part of the studies that considered the injection of high molecular weight as visco-supplementation, with a course of two to four injections a year.
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spelling pubmed-80962932021-05-05 Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines Pavone, Vito Vescio, Andrea Turchetta, Matteo Giardina, Serena Maria Chiara Culmone, Annalisa Testa, Gianluca Front Pharmacol Pharmacology Osteoarthritis (OA) is a leading cause of disability among older adults. Numerous pharmaceutical and nonpharmaceutical interventions have been described. Intra-articular injections are commonly the first line treatment. There are several articles, reporting the outcome of corticosteroids (CS), hyaluronic acid (HA) and platelet rich plasma (PRP). The aim of the study is to highlight the usefulness, indication and efficacy of the intra-articular injection of principal drugs. CSs have been shown to reduce the severity of pain, but care should be taken with repeated injections because of potential harm. HA reported good outcomes both for pain reduction and functional improvement. Different national societies guidelines do not recommend the PRP intra-articular injection in the management of knee OA for lack of evidence. In conclusion, the authors affirm that there is some evidence that intra-articular steroids are efficacious, but their benefit may be relatively short lived (<4 weeks). Most of the positive outcome were limited to the studies or part of the studies that considered the injection of high molecular weight as visco-supplementation, with a course of two to four injections a year. Frontiers Media S.A. 2021-04-20 /pmc/articles/PMC8096293/ /pubmed/33959026 http://dx.doi.org/10.3389/fphar.2021.661805 Text en Copyright © 2021 Pavone, Vescio, Turchetta, Giardina, Culmone and Testa. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Pavone, Vito
Vescio, Andrea
Turchetta, Matteo
Giardina, Serena Maria Chiara
Culmone, Annalisa
Testa, Gianluca
Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines
title Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines
title_full Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines
title_fullStr Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines
title_full_unstemmed Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines
title_short Injection-Based Management of Osteoarthritis of the Knee: A Systematic Review of Guidelines
title_sort injection-based management of osteoarthritis of the knee: a systematic review of guidelines
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8096293/
https://www.ncbi.nlm.nih.gov/pubmed/33959026
http://dx.doi.org/10.3389/fphar.2021.661805
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