TY - JOUR
T1 - Investigation Into the Effects of Intra-Articular Steroid on Post-Traumatic Osteoarthritis in Distal Radius Fractures
T2 - A Randomized Controlled Pilot Study
AU - Logli, Anthony L.
AU - Evans, Christopher H.
AU - Duryea, Jeffrey
AU - Larson, Dirk R.
AU - Bakri, Karim
AU - Carlsen, Brian T.
AU - Dennison, David G.
AU - Karim, Kristin E.
AU - Pulos, Nicholas A.
AU - Rhee, Peter C.
AU - Rizzo, Marco
AU - Shin, Alexander Y.
AU - Elhassan, Bassem T.
AU - Kakar, Sanjeev
N1 - Publisher Copyright:
© 2023 American Society for Surgery of the Hand
PY - 2024
Y1 - 2024
N2 - Purpose: The aim of this prospective, randomized, controlled, double-blinded pilot study was to determine the rates of post-traumatic osteoarthritis and assess joint space width in the presence or absence of a single intra-articular injection of corticosteroid after an acute, intra-articular distal radius fracture (DRF). Methods: Forty patients received a single, intra-articular, radiocarpal joint injection of 4 mg of dexamethasone (DEX) (n = 19) or normal saline placebo (n = 21) within 2 weeks of a surgically or nonsurgically treated intra-articular DRF. The primary outcome measure was minimum radiocarpal joint space width (mJSW) on noncontrast computed tomography scans at 2 years postinjection. Secondary outcomes were obtained at 3 months, 6 months, 1 year, and 2 years postinjection and included Disabilities of the Arm, Shoulder, and Hand; Michigan Hand Questionnaire; Patient-Rated Wrist Evaluation; wrist range of motion; and grip strength. Results: At 2-year follow-up, there was no difference in mean mJSW between the DEX group (2.2 mm; standard deviation, 0.6; range, 1.4–3.2) and the placebo group (2.3 mm; standard deviation, 0.7; range, 0.9–3.9). Further, there were no differences in any secondary outcome measures at any postinjection follow-up interval. Conclusions: Radiocarpal joint injection of corticosteroid within 2 weeks of an intra-articular DRF does not appear to affect the development of post-traumatic osteoarthritis within 2 years follow-up in a small pilot cohort. Type of study/level of evidence: Therapeutic II.
AB - Purpose: The aim of this prospective, randomized, controlled, double-blinded pilot study was to determine the rates of post-traumatic osteoarthritis and assess joint space width in the presence or absence of a single intra-articular injection of corticosteroid after an acute, intra-articular distal radius fracture (DRF). Methods: Forty patients received a single, intra-articular, radiocarpal joint injection of 4 mg of dexamethasone (DEX) (n = 19) or normal saline placebo (n = 21) within 2 weeks of a surgically or nonsurgically treated intra-articular DRF. The primary outcome measure was minimum radiocarpal joint space width (mJSW) on noncontrast computed tomography scans at 2 years postinjection. Secondary outcomes were obtained at 3 months, 6 months, 1 year, and 2 years postinjection and included Disabilities of the Arm, Shoulder, and Hand; Michigan Hand Questionnaire; Patient-Rated Wrist Evaluation; wrist range of motion; and grip strength. Results: At 2-year follow-up, there was no difference in mean mJSW between the DEX group (2.2 mm; standard deviation, 0.6; range, 1.4–3.2) and the placebo group (2.3 mm; standard deviation, 0.7; range, 0.9–3.9). Further, there were no differences in any secondary outcome measures at any postinjection follow-up interval. Conclusions: Radiocarpal joint injection of corticosteroid within 2 weeks of an intra-articular DRF does not appear to affect the development of post-traumatic osteoarthritis within 2 years follow-up in a small pilot cohort. Type of study/level of evidence: Therapeutic II.
KW - Corticosteroid
KW - dexamethasone (DEX)
KW - distal radius fracture (DRF)
KW - post-traumatic osteoarthritis (PTOA)
KW - randomized controlled trial (RCT)
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U2 - 10.1016/j.jhsa.2023.11.026
DO - 10.1016/j.jhsa.2023.11.026
M3 - Article
C2 - 38180412
AN - SCOPUS:85181838387
SN - 0363-5023
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
ER -