Usefulness of intra-articular botulinum toxin injections. A systematic review

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• 作者：Hichem Khenioui^a ; ^b ; ^c ; ^{Khenioui.Hichem@ghicl.net" class="auth_mail" title="E-mail the corresponding author} ; Eric Houvenagel^b ; ^c ; ^d ; Jean Franç ; ois Catanzariti^a ; ^b ; ^d ; ^e ; Marc Alexandre Guyot^a ; ^b ; ^d ; Olivier Agnani^a ; ^b ; ^d ; Cé ; cile Donze^a ; ^b ; ^d
• 关键词：Botulinum toxin ; Intra articular injection ; Osteoarthritis ; Adhesive capsulitis of shoulder ; Rheumatology
• 刊名：Joint Bone Spine
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：83
• 期：2
• 页码：149-154
• 全文大小：505 K

文摘

Botulinum toxin is a proven and widely used treatment for numerous conditions characterized by excessive muscular contractions. Recent studies have assessed the analgesic effect of botulinum toxin in joint pain and started to unravel its mechanisms.

Literature-search-methodology

We searched the international literature via the Medline database using the term “intraarticular botulinum toxin injection” combined with any of the following terms: “knee”, “ankle”, “shoulder”, “osteoarthritis”, “adhesive capsulitis of the shoulder”.

Results

Of 16 selected articles about intraarticular botulinum toxin injections, 7 were randomized controlled trials done in patients with osteoarthritis, adhesive capsulitis of the shoulder, or chronic pain after joint replacement surgery. Proof of anti-nociceptive effects was obtained in some of these indications and the safety and tolerance profile was satisfactory. The studies are heterogeneous. The comparator was usually a glucocorticoid or a placebo; a single study used hyaluronic acid. Pain intensity was the primary outcome measure.

Discussion-conclusion

The number of randomized trials and sample sizes are too small to provide a satisfactory level of scientific evidence or statistical power. Unanswered issues include the effective dosage and the optimal dilution and injection modalities of botulinum toxin.