Ultrasound-Guided Pes Anserine Bursitis Injection Choices: Prolotherapy or Oxygen-Ozone or Corticosteroid: A Randomized Multicenter Clinical Trial

OBJECTIVE

Pes anserine bursitis is the most common cause of periarticular knee pain. The aim of the study was to evaluate the efficacy of local injection-based therapies with different materials.

DESIGN

The enrolled patients were randomly allocated to three groups to receive different interventions. Outcome measures included pain severity using the visual analog scale and the Western Ontario and McMaster Universities osteoarthritis index that was evaluated before the intervention, 1 and 8 wks after that.

RESULTS

This trial was performed on 72 participants, with male-to-female ratio of 0.14 and with a mean age of 61.49 ± 9.35 yrs. Corticosteroids in the first group, oxygen-ozone in the second group, and dextrose 20% in the third group, were injected into the pes anserine bursa under ultrasound guidance. Interaction between time and group showed a statistically significant improvement in visual analog scale and Western Ontario and McMaster Universities Arthritis Index ( P ≤ 0.05) in favor of corticosteroids and oxygen-ozone groups after 1 wk and in favor of oxygen-ozone and prolotherapy groups after 8 wks.

CONCLUSIONS

All three treatment options are effective for patients with pes anserine bursitis. This study showed that the effects of oxygen-ozone injection and prolotherapy last longer than those of corticosteroid injection.

Ultrasound-Guided vs. Blind Coccygeal Corticosteroid Injections for Chronic Coccydynia: A Randomized, Clinical Trial

BACKGROUND

Corticosteroid injection is frequently used for chronic coccydynia management. Ultrasonography can be used to improve the accuracy of the injection. This study aims to assess the clinical outcome of ultrasound-guided compared to blind coccygeal injection in chronic coccydynia.

METHODS

Thirty patients with chronic coccydynia were randomized into two groups and received a coccygeal corticosteroid injection at maximum tenderness point: 15 patients with and 15 patients without ultrasound guidance. The patient's pain was evaluated with the visual analog scale (VAS) at 1-, 4-, 8-, and 24-week postinjection. Furthermore, the Dallas Pain Questionnaire was assessed before injection; also, four and eight weeks after treatment. The quality of life of patients was evaluated before an assessment and four weeks after the intervention by the SF-36 questionnaire.

RESULTS

The VAS score decreased significantly 24-week after the intervention in both ultrasound-guided and blinded groups (P < .001), without any significant difference between the groups (P = .964). Similarly, the Dallas pain scale had a significant decrease at eight weeks after intervention in both groups (P < .001) with no significant difference between the groups (P = .972). Although there was a significant improvement in the patient's quality of life in each group eight weeks after the intervention, it was not significantly different between the two groups. Neither of the treatment groups had any adverse effects associated with the injection.

CONCLUSION

There were no significant differences in the clinical outcome of coccygeal ultrasound-guided vs. blind steroid injection for chronic coccydynia.