Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study


Kose S. G., Kose H. C., Celikel F., Tulgar S., Akkaya O. T.

Korean Journal of Pain, cilt.36, sa.2, ss.195-207, 2023 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 36 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.3344/kjp.22325
  • Dergi Adı: Korean Journal of Pain
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Directory of Open Access Journals
  • Sayfa Sayıları: ss.195-207
  • Anahtar Kelimeler: Chronic Pain; Hip; Injections, Hip; Pain Management; PENG Block; Quality of Life; Steroids; Ultrasonography, Interventional, Intra-Articular; Osteoarthritis
  • Samsun Üniversitesi Adresli: Hayır

Özet

Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen’s d = 4.62), and IAI group at 4 (Cohen’s d = 5.15) and 8 (Cohen’s d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen’s d = 2.16, P = 0.007) and WOMAC (Cohen’s d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.