Knee Osteoarthritis
Conditions
Keywords
knee injection, Knee osteoarthritis, corticosteroid
Brief summary
To evaluate pain relief from corticosteroid injection with and without anesthetic as well as with variable volume of anesthetic. Pain relief will be measured using the VAS pain score at the time of the injection as well as several time points following the injection to capture pain relief longevity. The investigators intend to evaluate how well the patients tolerate corticosteroid mixtures without anesthetic as well as with different volumes of anesthetic. Primary measure will be the time from procedure when postoperative status is considered success (as measured by global perceived improvement score).
Detailed description
Primary objective is to evaluate pain relief from corticosteroids, Kenalog without anesthetic as well as with different volumes of anesthetic. The investigators will measure the VAS pain score at the time of the injection as well as several time points following the injection. Additionally, the investigators will evaluate how long the injection provided pain relief for the patient. The secondary intend is to evaluate how well the patients tolerate Kenalog mixtures without anesthetic as well as with different volumes of anesthetic by using the VAS pain scale. The investigators hypothesize that patient with lower volume of injection will experience less pain during the procedure and that there will be no statistically significant difference in pain level between the study groups during the study period.
Interventions
DRUGKenalog with bupivacaine Injection
Indications, relevant for this study include Kenalog injection for knee pain from osteoarthritis or inflammatory arthritis. A single injection to a patient who has no known allergies to anesthetic or corticosteroids would be administered during a scheduled clinical visit.
Sponsors
Florida Orthopaedic Institute
Foundation for Orthopaedic Research and Education
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
The PI standard of care is to offer patients who complain of knee pain a corticosteroids injection regardless of patient participation in a study. A consent will be obtained prior the injection by a trained/qualified team member. Subjects will be randomly allocated to groups by concealed allocation. Randomization sequence between three groups will be created using Excel and will be further stratified by sex within each block, to ensure even distribution. A set of numbered envelopes will be created, with each having one unique group assigned. A staff member will assign an envelope with group assignment upon consent and record envelope number ID. The ARNP will open an envelope, administer injection based on the group assigned. The ARNP will prepare the medication to maintain the double blinded aspect of the study. The ARNP is trained and experienced with injections and has giving injections for several years. She will not be involved in the evaluations of the patient pre/post injection.
Intervention model description
At screening/baseline, informed consent will be obtained, demographics and medical history will be collected, patient x-ray will be reviewed/KL grade confirmed, narcotic use in last 6 months will be screened using E-FORCSE (Florida Prescription Drug Monitoring Program) database, inclusion and exclusion criteria will be assessed, and patient will be randomized into one of the study groups. We will only include patients who are receiving unilateral knee injections. Further, patient's baseline information on VAS Pain and current medication (analgesic or NSAID) will be collected. VAS Pain will be also collected immediately after the intervention and 2 minutes after the intervention, in addition to global perceived improvement score and AEs. The intervention in this study is intra-articular knee injection of synthetic corticosteroid (kenalog) and variable amount of anesthetic (0ml, 2ml or 4 ml of 0.25% bupivacaine).
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Patients must be 18 years of age and be able to consent for themselves. 2. OA grade Kellgren Lawrence Stage II or III. 3. Diagnosis of primary osteoarthritis.
Exclusion criteria
1. Patients with other forms of arthritis such as inflammatory arthritis. 2. History of narcotic use for the past 6 months. 3. Kellgren Lawrence arthritis grade 1 or 4. 4. Pregnant women and prisoners.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Injection for Knee Pain | Prior to procedure (in office) | Visual Analogue Scale (VAS) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of Knee Pain | Immediate Post-op (in office) | Global Perceived Improvement |
Other
| Measure | Time frame | Description |
|---|---|---|
| Medications | Prior to procedure (in office) | Review of Medications |
| Review of Adverse Events | Immediate post procedure (in office) | Any issues with procedure |
Countries
United States
Contacts
Primary ContactAnne Meredith Baldy, CCRC
Backup ContactDebbi Warren, RN
Outcome results
None listed