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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 2000 Giugno;35(2):61-6
Value of hip anesthesia to characterize the main origin of pain in hip-spine osteoarthritis
Poiraudeau S. 1, Martinez M. 1, Anract P. 2, Chevrot A. 3, Revel M. 1
1 Hôpital Cochin, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Université René Descartes, Paris;
2 Service d’Orthopédie B, Paris;
3 Service de Radiologie
BACKGROUND: To evaluate the value of lidocaine hip injection to determine the main origin of pain in patients with clinical and radiological evidence of hip and spine osteoarthritis.
METHODS: Retrospective study with a mean follow-up of 28 months. Ambulatory care patients were referred to the department for injection of ten milliliters of 2% lidocaine into the hip joint under fluoroscopic control. During the same procedure, 1.5ml (3.75 mg) of cortivazol could also be injected according to the recommendations of the patient’s physician. The hip was considered as the main origin of pain when 20 to 30 minutes after the intraarticular injection, the patient noted a decrease of at least 75% of his usual symptoms. Corticoid hip injection or total hip arthroplasty results were evaluated at least 6 months after treatment by a mailed questionnaire on a 5-level semi-quantitative scale (0 = null, 1 = poor, 2 = fair, 3 = good, 4 = excellent).
RESULTS: Ninety patients were evaluated. The test was positive in 44 patients. Twenty of these 44 patients underwent total hip arthroplasty (THA), 18 with excellent results. A corticosteroid hip injection was administered to 26 positive test patients and 17 had excellent or good results. Nine patients with a negative test underwent THA; only 5 had excellent or good results. A corticosteroid hip injection was administered in 24 negative test patients; only one had good results. For THA, the test had a sensitivity of 0.78 and a specificity of 0.67, a positive predictive value of 0.90 and a negative predictive value of 0.45, with an efficiency of 0.76. For corticosteroid injection, the test had a sensitivity of 0.94 and a specificity of 0.71, a positive predictive value of 0.65 and a negative predictive value of 0.96, with an efficiency of 0.80.
CONCLUSIONS: Lidocaine hip injection appears to be a useful tool to determine the origin of pain in patients with hip and spine osteoarthritis and to predict the outcome of THA and corticoid hip injection.