POS1347 EVALUATING THE EFFICACY OF LOCAL CORTICOSTEROID INJECTION, PLATELET-RICH PLASMA, AND EXTRACORPOREAL SHOCKWAVE THERAPY IN PATIENTS WITH PES ANSERINE BURSITIS: A PILOT RANDOMIZED, COMPARATIVE CLINICAL TRIAL

• Published in: Annals of the rheumatic diseases Vol. 82; no. Suppl 1; pp. 1024 - 1025
• Main Authors: Gouda, W A, Abbas, A S, Abdel-Aziz, T M, Shoaeir, M Z, Moshrif, A, Mosallam, A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2023
• Subjects: Acetic acid; Anesthetics; Bursitis; Clinical trials; Corticosteroids; Inflammation; Injection; Knee; Lithotripsy; Local anesthetics; Methylprednisolone; Nonsteroidal anti-inflammatory drugs; Osteoarthritis; Pain; Patients; Physical activity; Platelets; Quality of life; Rehabilitation; Rheumatology; Statistical analysis; Steroids
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2023-eular.4782

BackgroundPes anserine bursitis is one of the causes of painful knee syndromes. It limits physical activity and impairs the quality of life of a patient. Obesity and osteoarthritis (OA) of the knee are common predisposing factors for pes anserine bursitis. It is treated with non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy, injections of local anesthetics, and corticosteroids. This study examines the efficacy of local corticosteroid injection, Platelet-rich plasma (PRP) injection, and extracorporeal shock wave therapy (ESWT) as different modalities to alleviate pain and improve function in patients with pes anserine bursitis.ObjectivesThis study examines the efficacy of local corticosteroid injection, Platelet-rich plasma (PRP) injection, and extracorporeal shock wave therapy (ESWT) as different modalities to alleviate pain and improve function in patients with pes anserine bursitis.MethodsThis randomized comparative clinical trial was performed between July 2021 and June 2022 in the rheumatology and rehabilitation department at Al-Azhar University hospitals in Egypt on 180 patients diagnosed with chronic pes anserine bursitis according to Larson and Baum criteria. The enrolled patients were divided into three groups, each including sixty patients. Group I received a local corticosteroid injection of 40 mg of methylprednisolone acetate/1 ml (n = 60); Group II received a PRP injection (n = 60); and in Group III, ESWT (n = 60) was used. The Visual Analog Scale (VAS), Western Ontario and McMaster Universities (WOMAC) pain score, WOMAC physical function score, and Ritchie score for tenderness were recorded at the baseline, after 1 week, and after 8 weeks.ResultsThere are significant differences between the corticosteroid group compared to the PRP group (10.6± 2.5) and the ESWT group (9.7 ±2.6) regarding the WOMAC pain score and WOMAC physical function score one week after the application of procedures. There is a highly statistically significant (p= 0.001) decreased 8-week WOMAC pain score in the corticosteroid group (5.7 ± 2.7) when compared to the PRP group (9.4± 2.4) and ESWT group (7.1± 1.5) Table [1]. As regards VAS, there isn’t a statistically significant difference (p = 0.636) between the studied groups as regards baseline VAS or 8-week VAS after the procedure.ConclusionAn examination of Pes anserine bursitis is essential and shouldn’t be missed in knee OA patients complaining of pain. Our findings show that local corticosteroid injection is more effective than PRP injection and ESWT for pain relief.DeclarationsThe authors declare that they have no competing interests.Table (1):Post hoc analysis for multiple comparisons between studied groups as regard 1-week WOMAC score (pain & physical function) after the application of procedures.1 weekCorticosteroid vs PRPCorticosteroid vs ESWTPRP vs ESWTWOMAC pain scoreLSD3.062.10.93p-value< 0.001 HS0.001 S0.126 NSWOMAC physical function scoreLSD3.29.16.0p-value0.120 NS< 0.001 HS0.004 SS: p-value < 0.05 is considered significant.HS: p-value < 0.001 is considered highly significant.LSD: Least sig. difference. NS: p-value > 0.05 is considered non-significant.Disclosure of InterestsNone Declared.