Ultrasound guided intra-articular ketorolac versus corticosteroid injection in osteoarthritis of the hip: a retrospective comparative study

Abstract

The treatment of osteoarthritis of the hip with intra-articular ketorolac injection is as effective as that with intra-articular corticosteroid injection. Intra-articular ketorolac injection can be considered useful for patients with contraindications to using corticosteroids.

Efficacy of Injected Corticosteroid Type, Dose, and Volume for Pain in Large Joints: A Narrative Review

“…Several studies have examined the efficacy of intra‐articular hip steroid injections. Most placebo‐controlled trials demonstrate short‐term improvement (ranging from 1‐6 months) in pain and functional scores [51‐58].…”

“…However, shortcomings of the methodology used in this meta‐analysis have been highlighted [92], and, as such, this recommendation remains controversial. Ketorolac [57,95‐97], platelet‐rich plasma [98], and stem cell [99] injections for symptomatic knee OA have been studied, but these agents remain investigational and are not currently considered standard of care, given that the literature supporting their use is still growing and has shown mixed results thus far.…”

Standard and Advanced Imaging of Hip Osteoarthritis. What the Radiologist Should Know

“…58 Despite the widespread use of hip injections, there are no universally agreed upon algorithms or specific injectates used for hip OA. [59][60][61][62][63][64][65][66][67][68] If the possibility of infection has been excluded, a common approach is to start with an intraarticular hip steroid injection or combination of steroid and anesthetic. If there is pain relief, this indicates the hip (and not a referred source such as the spine) is the culprit.…”

“…Multiple injectates are available on the market including steroids (i.e., methylprednisolone and triamcinolone) and anesthetics (i.e., ropivacaine and bupivacaine), with lower doses of ropivacaine currently considered to be less chondrotoxic. [59][60][61][62] If hip pain responders are referred for additional treatments, injectates such as hyaluronic acid (HA), platelet-rich plasma (PRP), stem cells, or polynucleotides may be considered. [63][64][65][66][67][68] However, more prospective randomized trials that assess the long-term success in the hip are needed.…”

“…59 Injections in appropriately selected patients have proven efficacious, and patients have reported improved pain scores immediately after corticosteroid injection and up to 6 months afterward. [60][61][62] In terms of patient preference, Byrd and colleagues discovered that patients who had both ultrasound and fluoroscopic injections preferred ultrasound in terms of convenience and procedural pain. 59 In cases where patients are unable to tolerate corticosteroids, ketorolac (nonsteroidal anti-inflammatory) may be used, bearing in mind the complications of acute renal failure and increased bleeding risk.…”