Ultrasound guided injection of a painful knee osteoarthritis with medial meniscus extrusion: a case series study

Background: Meniscal subluxation results in the natural history of knee osteoarthritis (OA). Periarticular infiltration should minimize possible complications related to penetration of corticosteroids into the joint space in the treatment of knee OA.According to pain relief and improvement of function, the aim of this study is to evaluate the effectiveness of perimeniscal corticosteroid ultrasound guided injection in knee OA.Methods: Thirty-two patients received an injection of 0.5 ml of methylprednisolone-acetate around perimeniscal tissues. Outcome measures were pain relief and knee function, assessed by Visual Analogue Scale (VAS) [24, 29, 30] measured at rest (VAS-R) and during stairs climbing (VAS-C) and by Italian-Western Ontario and McMaster Universities (WOMAC) scale. Clinical evaluation was performed at baseline, at 1 and 4 weeks of follow-up.Results: Mean baseline values of VAS-R and VAS-C were 6.79 +/- 1.17 and 7.6 +/- 1.39, respectively. All subjects showed a significant reduction in pain over time (p<0.001). Mean baseline values of WOMAC pain, stiffness and physical function were 5.56 +/- 1.32, 4.39 +/- 1.91 and 4.63 +/- 2.31, respectively. According to WOMAC stiffness and physical function was not found a significant improvement over time (p>0.05).Conclusion: Corticosteroid perimeniscal ultrasound guided injection can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with knee OA.