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Hip Injection

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161. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. Full Text available with Trip Pro

, Australia.Individuals aged 35-70 years, with lateral hip pain for more than 3 months, at least 4/10 on the pain numerical rating scale, and gluteal tendinopathy confirmed by clinical diagnosis and MRI; and with no corticosteroid injection use in previous 12 months, current physiotherapy, total hip replacement, or neurological conditions.A physiotherapy led education and exercise programme of 14 sessions over 8 weeks (EDX; n=69), one corticosteroid injection (CSI; n=66), and a wait and see approach (WS; n=69 (...) Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. To compare the effects of a programme of load management education plus exercise, corticosteroid injection use, and no treatment on pain and global improvement in individuals with gluteal tendinopathy.Prospective, three arm, single blinded, randomised clinical trial.Brisbane and Melbourne

2018 British Journal of Sports Medicine Controlled trial quality: predicted high

162. The PRECISION Survey: Preferences of Physicians Regarding Ultrasound-Guided Intra-Articular Injections. (Abstract)

injections of the knee, shoulder, and/or hip. After validation by the focus group, the final survey (28 questions) was e-mailed to members of the Canadian Academy of Sport and Exercise Medicine (N = 632).A total of 168 responses were received (26.6%). Nearly half of respondents rarely/never had access to UGII equipment (48.5%), and over half did not have adequate training in UGIIs (56.8%-68.8%). About half of respondents agreed that UGII improves accuracy in knee injections (50.9%); only 35.4% agreed (...) there was evidence to support UGII over non-ultrasound-guided intra-articular injections (NGIIs) of the knee. Physicians younger than 50 years were significantly more likely to use UGII for the knee and hip if they had better access to equipment (P < 0.0005 for both); they were more likely to use UGII for the knee if it was less time-consuming (P = 0.001).The majority of respondents are not using UGII for the knee or shoulder. Physicians may overestimate their accuracy in performing NGIIs. The biggest barriers

2018 Clinical Journal of Sport Medicine

163. Ultrasound-guided Intraarticular Hip Injection for Osteoarthritis Pain in the Emergency Department Full Text available with Trip Pro

Ultrasound-guided Intraarticular Hip Injection for Osteoarthritis Pain in the Emergency Department Ultrasound-guided intraarticular hip corticosteroid injections may be useful for emergency care providers treating patients with painful exacerbations of osteoarthritis of the hip. Corticosteroid injection is widely recommended as a first-line treatment for painful osteoarthritis of the hip. Bedside ultrasound is readily available in most emergency departments; however, using ultrasound to guide (...) therapeutic hip injections has not yet been described in emergency practice. Herein, we present the first description of a successful emergency physician-performed ultrasound-guided hip injection of local anesthetic and corticosteroid for pain control in a patient with an acute exacerbation of osteoarthritis.

2013 Western Journal of Emergency Medicine

164. Intra-articular corticosteroid injection in osteoarthritis of the knee and hip: factors predicting pain relief--a systematic review. (Abstract)

Intra-articular corticosteroid injection in osteoarthritis of the knee and hip: factors predicting pain relief--a systematic review. Variations in the degree of pain relief reported by patients with osteoarthritis following intra-articular corticosteroid injections are well recognized but the reasons for this are not widely understood and factors which might predict variations in response have not been subjected to systematic review. We set out to review systematically the literature relating (...) to predictors of pain reduction following intra-articular corticosteroid injections in patients with knee and hip osteoarthritis.Searches were performed using Medline, EMBASE, Web of Knowledge and MeSH search of Pubmed, the last search being performed in August 2012. Search terms included knee osteoarthritis, hip osteoarthritis, corticosteroid and related terms, and intra-articular injection. Papers were selected and reviewed by 2 reviewers. For inclusion, papers were required to describe studies in which

2013 Seminars in arthritis and rheumatism

165. Individual patient data meta-analysis of trials investigating the effectiveness of intra-articular glucocorticoid injections in patients with knee or hip osteoarthritis: an OA Trial Bank protocol for a systematic review. Full Text available with Trip Pro

Individual patient data meta-analysis of trials investigating the effectiveness of intra-articular glucocorticoid injections in patients with knee or hip osteoarthritis: an OA Trial Bank protocol for a systematic review. Based on small to moderate effect sizes for the wide range of symptomatic treatments in osteoarthritis (OA), and on the heterogeneity of OA patients, treatment guidelines for OA have stressed the need for research on clinical predictors of response to different treatments (...) on the rules for cooperation in a consortium; and to develop and explore the methodological issues of meta-analysis with individual OA patient data.For the current IPD analysis we will collect and synthesize IPD from randomized trials studying the effect of intra-articular glucocorticoid injections in patients with hip or knee OA. Subgroup analyses will be performed for the primary outcome of pain at both short-term and long-term follow-up, in the subgroups of patients with and without severe pain

2013 Systematic reviews

166. A study of the usefulness of a periarticular multimodal drug cocktail injection for pain management after total hip arthroplasty. Full Text available with Trip Pro

A study of the usefulness of a periarticular multimodal drug cocktail injection for pain management after total hip arthroplasty. Measures for pain management after total hip arthroplasty (THA) are important for early improvement in the quality of life after operation and early postoperative rehabilitation. We investigated the analgesic effect of locally injected drugs around the total hip prosthesis.54 patients undergoing THA were randomized either to receive a periarticular intraoperative (...) injection of a 30-ml mixture containing morphine hydrochloride 10 mg, 0.5% bupivacaine 20 ml, epinephrine 0.3 mg, and saline 8.7 ml or to receive no injection. The perioperative analgesic regimen was standardized. The evaluation items included assessment of pain using a 100-point visual analog scale (VAS) after the patients awoke on the day of the operation and on postoperative day 1, the dose of diclofenac sodium suppository, the number of days for acquiring assisted ambulation with a walking cane

2013 Journal of orthopaedics Controlled trial quality: uncertain

167. The Anterior Approach for a Non-Image-Guided Intra-articular Hip Injection. (Abstract)

The Anterior Approach for a Non-Image-Guided Intra-articular Hip Injection. The purpose of this study was to investigate and validate the accuracy and safety of a technique using an anterior approach for non-image-guided intra-articular injection of the hip by use of anatomic landmarks.We enrolled 55 patients. Injections were performed before supine hip arthroscopy after landmarking and before application of traction. After the needle insertion, success was confirmed with an air arthrogram (...) and by direct visualization after arthroscope insertion. Accuracy and difficulty achieving correct needle placement were correlated with age, weight, height, body mass index, body type, gender, and surgical indication, as well as femoral and pelvic morphology. Forty-five patients who underwent injection in the office were followed up separately to document injection side effects. Needle placement accuracy was correlated to patients' demographics. All statistical tests with P values were 2 sided

2013 Arthroscopy

168. Ultrasound-guided injection for MR arthrography of the hip: comparison of two different techniques. (Abstract)

Ultrasound-guided injection for MR arthrography of the hip: comparison of two different techniques. The purpose of this study was to prospectively evaluate the two different ultrasound-guided injection techniques for MR arthrography of the hip.Fifty-nine consecutive patients (21 men, 38 women) referred for MR arthrographies of the hip were prospectively included in the study. Three patients underwent bilateral MR arthrography. The two injection techniques were quantitatively and qualitatively (...) compared. Quantitative analysis was performed by the comparison of injected contrast material volume into the hip joint. Qualitative analysis was performed with regard to extraarticular leakage of contrast material into the soft tissues. Extraarticular leakage of contrast material was graded as none, minimal, moderate, or severe according to the MR images. Each patient rated discomfort after the procedure using a visual analogue scale (VAS).The injected contrast material volume was less in femoral head

2013 Skeletal radiology Controlled trial quality: uncertain

169. The Efficacy of Periarticular Multimodal Drug Injection for Postoperative Pain Management in Total Knee or Hip Arthroplasty. (Abstract)

The Efficacy of Periarticular Multimodal Drug Injection for Postoperative Pain Management in Total Knee or Hip Arthroplasty. The efficacy of periarticular multimodal drug injection (PMDI) to reduce pain after total knee or hip arthroplasty (TKA or THA) still remains controversial. Our study aimed at evaluating the efficacy of PMDI after TKA or THA. A fully recursive literature search was conducted to identify relevant randomized controlled trials. Ultimately, 21 studies were included

2013 Journal of Arthroplasty

170. Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System

patients undergoing hip or knee replacement surgery at a single centre in Israel. Patients were randomized to receive either compression therapy plus ASA (100 mg per day), or anticoagulation therapy (40 mg of enoxaparin once daily by injection). 6 The duration of therapy was not specified. A total of 121 patients (61 in the compression group and 60 in the anticoagulation group) completed the study and were included in analysis. Five to eight days after surgery, each patient received venograms or duplex (...) Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System | CADTH.ca CADTH Document Viewer Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System Table of Contents Search this document Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System March

2016 CADTH - Issues in Emerging Health Technologies

171. Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System

patients undergoing hip or knee replacement surgery at a single centre in Israel. Patients were randomized to receive either compression therapy plus ASA (100 mg per day), or anticoagulation therapy (40 mg of enoxaparin once daily by injection). 6 The duration of therapy was not specified. A total of 121 patients (61 in the compression group and 60 in the anticoagulation group) completed the study and were included in analysis. Five to eight days after surgery, each patient received venograms or duplex (...) Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System | CADTH.ca CADTH Document Viewer Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System Table of Contents Search this document Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery: The ActiveCare System March

2016 CADTH - Issues in Emerging Health Technologies

172. Chronic Hip Pain

Procedure Rating Comments RRL* X-ray pelvis 9 X-ray pelvis and x-ray hip are complementary. ?? X-ray hip 9 X-ray pelvis and x-ray hip are complementary. ??? MRI hip without IV contrast 1 O MRI hip without and with IV contrast 1 O US hip 1 O CT hip without IV contrast 1 ??? CT hip with IV contrast 1 ??? CT hip without and with IV contrast 1 ??? CT arthrography hip 1 ??? MR arthrography hip 1 O Tc-99m bone scan hip 1 ??? F-18 fluoride PET hip 1 ??? Image-guided anesthetic +/- corticosteroid injection hip (...) joint or surrounding structures 1 Varies Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level Variant 2: Chronic hip pain. Radiographs negative, equivocal, or nondiagnostic. Suspect extra- articular noninfectious soft-tissue abnormality, such as tendonitis. Radiologic Procedure Rating Comments RRL* MRI hip without IV contrast 9 O US hip 7 O Image-guided anesthetic +/- corticosteroid injection hip joint or surrounding structures 5

2016 American College of Radiology

173. Osteonecrosis of the Hip

Osteonecrosis of the Hip Date of origin: 1995 Last review date: 2015 ACR Appropriateness Criteria ® 1 Osteonecrosis of the Hip American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Osteonecrosis of the Hip Variant 1: Adult or Child. Clinically suspected osteonecrosis. First study. Radiologic Procedure Rating Comments RRL* X-ray pelvis and hips 9 This procedure includes the frog-leg view. The RRL for the adult procedure is ???. ???? CT hips without IV contrast 1 (...) The RRL for the adult procedure is ???. ???? CT hips with IV contrast 1 The RRL for the adult procedure is ???. ???? CT hips without and with IV contrast 1 The RRL for the adult procedure is ????. ????? Tc-99m bone scan with SPECT hips 1 The RRL for the adult procedure is ???. ???? MRI hips without IV contrast 1 O MRI hips without and with IV contrast 1 O Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level Variant 2: Adult

2015 American College of Radiology

174. Imaging after Total Hip Arthroplasty

Comments RRL* X-ray hip 9 ??? CT hip without IV contrast 5 ??? Tc-99m bone scan hip 5 ??? X-ray arthrography hip 5 ? Tc-99m nuclear arthrography hip 4 ??? FDG-PET hip 3 ??? F-18 fluoride PET hip 3 ??? Image-guided anesthetic injection of hip 3 A positive study usually indicates an articular cause for pain. Varies MRI hip without IV contrast 3 O CT hip with IV contrast 1 ??? CT hip without and with IV contrast 1 ??? MRI hip without and with IV contrast 1 O Rating Scale: 1,2,3 Usually not appropriate (...) Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level Variant 8: Total hip arthroplasty; suspect iliopsoas bursitis or tendinitis. Radiologic Procedure Rating Comments RRL* X-ray hip 9 This procedure is complementary to other studies. ??? MRI hip without IV contrast 8 This procedure is an alternative to US. O US hip 8 This procedure is an alternative to MRI. O Injection anesthetic iliopsoas tendon 6 Varies CT hip without IV contrast 4

2015 American College of Radiology

175. The Effectiveness of Autologous Platelet-Rich Plasma for Osteoarthritis of the Hip: A Retrospective Analysis. (Abstract)

-articular hip PRP injection. Outcomes were measured at baseline, two weeks, three months, and up to six months using the visual analog scale (VAS) for pain and the Hip Disability and Osteoarthritis Outcome Score (HOOS). The proportion of responders, as defined by a ≥50% reduction in VAS pain score, was assessed at three and six months.At two weeks, there was a significant improvement (P < 0.05) of function in two HOOS subscales: Symptoms and Activities of Daily Living. There was a significant (...) The Effectiveness of Autologous Platelet-Rich Plasma for Osteoarthritis of the Hip: A Retrospective Analysis. Platelet-rich plasma (PRP) is a minimally invasive treatment option to reduce pain and promote tissue healing. At the time this study was performed, there was limited published literature analyzing outcomes for patients treated with PRP for hip osteoarthritis.Thirty-six patients aged 49-85 (66.0 ± 12.1) years with chronic hip pain who met inclusion criteria underwent image-guided intra

2019 Pain Medicine

176. Fascia iliaca block in the emergency department for hip fracture: a randomized, controlled, double-blind trial. Full Text available with Trip Pro

from hip fracture.Thirty ASA I-III hip fracture patients over 70 years old, who received prehospital morphine, were randomized to receive either a fascia iliaca block using 30 ml of bupivacaine 0.5% with epinephrine 1:200,000 or a sham injection with normal saline. The fascia iliaca block was administered by emergency medicine physicians trained to perform an anatomic landmark-based technique. The primary outcome was the comparison between groups of the longitudinal pain score profiles at rest over (...) Fascia iliaca block in the emergency department for hip fracture: a randomized, controlled, double-blind trial. Hip fracture causes moderate to severe pain and while fascia iliaca block has been reported to provide analgesic benefit, most previous trials were unblinded, with subsequent high risks of performance, selection and detection biases. In this randomized, control double-blind trial, we tested the hypothesis that a fascia iliaca block provides effective analgesia for patients suffering

2019 BMC Geriatrics Controlled trial quality: predicted high

177. Impact of Local Infiltration Analgesia on the Quality of Recovery After Anterior Total Hip Arthroplasty: A Randomized, Triple-Blind, Placebo-Controlled Trial. (Abstract)

Impact of Local Infiltration Analgesia on the Quality of Recovery After Anterior Total Hip Arthroplasty: A Randomized, Triple-Blind, Placebo-Controlled Trial. Local infiltration analgesia (LIA) is commonly used in anterior total hip arthroplasty (THA) surgery; however, evidence for its efficacy is lacking. We hypothesized that LIA with 0.2% ropivacaine when compared with injection of placebo (0.9% saline) would improve patient quality of recovery on postoperative day (POD) 1, as measured

2019 Anesthesia and Analgesia Controlled trial quality: predicted high

178. The efficacy of fascia iliaca compartment block for pain control after hip fracture: A meta-analysis. Full Text available with Trip Pro

morphine consumption and the occurrence of nausea (P < .05). There was no significant difference between the pain intensity at 72 h (SMD = 0.11, 95% CI [-0.12, 0.34], P = .355).FICB has a beneficial role in reducing pain intensity and morphine consumption after hip fracture. Moreover, FICB has morphine-sparing effects when compared with a control group. More high-quality RCTs are needed to identify the optimal technique and volume of injectate for FICB. (...) The efficacy of fascia iliaca compartment block for pain control after hip fracture: A meta-analysis. To assess the effect of fascia iliaca compartment block (FICB) on pain control and morphine consumption in patients with hip fracture.We searched databases (PubMed, Embase, Cochrane Library) for eligible randomized controlled trials (RCTs) published prior to September 12, 2018. We only included hip fracture patients who received FICB versus placebo for pain control. Risk ratios (RRs), standard

2019 Medicine

179. How effective is periarticular drug infiltration in providing pain relief and early functional outcome following total hip arthroplasty? (Abstract)

How effective is periarticular drug infiltration in providing pain relief and early functional outcome following total hip arthroplasty? The aim of the study was to compare the efficacy of periarticular injection of a cocktail of analgesic drugs (PIC) with epidural infiltration (EA), in providing postoperative pain relief and early functional improvement following Total Hip Arthroplasty (THA).50 patients undergoing unilateral THA were randomized to receive either EA or PIC for postoperative

2019 Journal of clinical orthopaedics and trauma Controlled trial quality: uncertain

180. Tibialis posterior muscle pain effects on hip, knee and ankle gait mechanics. (Abstract)

Tibialis posterior muscle pain effects on hip, knee and ankle gait mechanics. Tibialis posterior (TP) dysfunction is a common painful complication in patients with rheumatoid arthritis (RA), which can lead to the collapse of the medial longitudinal arch. Different theories have been developed to explain the causality of tibialis posterior dysfunction. In all these theories, pain is a central factor, and yet, it is uncertain to what extent pain causes the observed biomechanical alterations (...) in the patients. The aim of this study was to investigate the effect of experimental tibialis posterior muscle pain on gait mechanics in healthy subjects.Twelve healthy subjects were recruited for this randomized crossover study. Experimental pain was induced by ultrasound-guided injection of 1 mL hypertonic saline into the upper part of the right tibialis posterior muscle with the use of isotonic saline as non-pain-inducing control. Subsequently, kinematic data during three self-paced over ground walking

2019 Human movement science Controlled trial quality: uncertain

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