Comparisons between lysis and lavage, intra-articular steroid injections, and three-point subsynovial steroid injections using operative single-cannula arthroscopy - A retrospective analysis

Abstract

The aim of this study is to compare the effectiveness of intra-articular and three-point sub-synovial steroid injections. In this retrospective Cohort study an OSCA lysis and lavage, intra-articular and threepoint sub-synovial steroid injections were performed and the maximal interincisinal opening (MIO), pain using 10- point visual analog scale (VAS) and quality of life (QOL) were measured one week before the procedure and 1, 3, 6, 12 months, and 2 and 3years after surgery. Sixty-five patients suffering from internal derangement refractory to conservative treatment charts were reviewed. successfully lowered pain (p value = 0.0012), and improved mouth opening (p value = 0.023), and quality of life (QoL) (p value = 0.003) for up to 6 months after surgery. OSCA with intra-articular CS injections effectively lowered pain (p value = 0.0025), and improved mouth opening (p value = 0.03) and QoL (p value = 0.004) for 12 months. In comparison, OSCA with sub-synovial steroid injections was significantly effective in lowering pain (p value = 0.000002), improving mouth opening (p value = 0.000004), and QoL (p value p = 0.000006) for the duration of the 36-month follow-up period within the limitations of the study it seems that the OSCA technique with site-specific, sub-synovial CS injections should be the preferred treatment approach when the priority is long-term success concerning pain relief, increased mouth opening and improved quality of life in Wilkes II-IV patients.

Keywords: Intra-articular corticosteroid injections; Lysis and lavage; Operative single-cannula arthroscopy (OSCA); Sub-synovial corticosteroid injections.