Assessing the Effectiveness of Ultrasound-Guided injections of Steroid for Knee Osteoarthritis on Three Different Sites: A Randomized Controlled Trial

Objective: The aim of this study was to explore the impact of ultrasound-guided injections at varioussites at the knee joint.Method: One hundred and twenty subjects with grade III and IV knee OA were enrolled in the study. Participants were randomly divided to receive ultrasound-guided intra-articular injections of Hyaluronic Acid using the envelop method of simple random technique into three of the treatment groups i.e. Group A, B, and C receiving Superolateral US-guided IA, mid medial US-guided IA, and mid-lateral US-guided IA injections respectively. The study involved grade III and grade IV osteoarthritis patients with bilateral knee OA based on the radiographic criteria, both male and female ages from 50 to 70 years. Exclusion included: Knee having mechanical deconditioning, fibromyalgia, microcrystalline arthropathy, or history of knee injury/surgery. Post-injection, the knee was immobilized for 5 minutes to prevent contrast medium diffusion into neighboring tissues, followed by radiography. Patients were provided with ice packs for localized pain relief and prescribed nonsteroidal anti-inflammatory agents for any discomfort due to steroid-induced crystalline bursitis.Results: 100% injection accuracy was observed in subjects with grade III and IV OA patients for the medial approach and 95% for the mediolateral approach. There was no statistical difference seen in all three methods.Conclusion: This paper shows the effectiveness of ultrasound guided intra articular injection of Steroids in the treatment of knee OA supporting the clinical application of ultrasound guided injections to improve outcomes in the treatment of knee OA.