Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World Registry

Background: Since the mid-20th century, knee osteoarthritis (OA) has doubled in prevalence, costing more than $27 billion annually. This study aimed to compare 6 nonoperative treatment options for knee OA (cryoneurolysis with superficial nerve block, cryoneurolysis with deep nerve block, intra-artic...

Full description

Saved in:
Bibliographic Details
Main Authors: Michael A. Mont, MD, Jennifer H. Lin, PhD, Andrew I. Spitzer, MD, Vinod Dasa, MD, Adam Rivadeneyra, MD, David Rogenmoser, DO, Andrew L. Concoff, MD, Mitchell K. Ng, MD, Mary DiGiorgi, PhD, MPH, Stan DySart, MD, Joshua Urban, MD, William M. Mihalko, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Arthroplasty Today
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352344125000421
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849770115445293056
author Michael A. Mont, MD
Jennifer H. Lin, PhD
Andrew I. Spitzer, MD
Vinod Dasa, MD
Adam Rivadeneyra, MD
David Rogenmoser, DO
Andrew L. Concoff, MD
Mitchell K. Ng, MD
Mary DiGiorgi, PhD, MPH
Stan DySart, MD
Joshua Urban, MD
William M. Mihalko, MD, PhD
author_facet Michael A. Mont, MD
Jennifer H. Lin, PhD
Andrew I. Spitzer, MD
Vinod Dasa, MD
Adam Rivadeneyra, MD
David Rogenmoser, DO
Andrew L. Concoff, MD
Mitchell K. Ng, MD
Mary DiGiorgi, PhD, MPH
Stan DySart, MD
Joshua Urban, MD
William M. Mihalko, MD, PhD
author_sort Michael A. Mont, MD
collection DOAJ
description Background: Since the mid-20th century, knee osteoarthritis (OA) has doubled in prevalence, costing more than $27 billion annually. This study aimed to compare 6 nonoperative treatment options for knee OA (cryoneurolysis with superficial nerve block, cryoneurolysis with deep nerve block, intra-articular hyaluronic acid injections, nonsteroidal inflammatory drug injections, IA corticosteroids, and IA triamcinolone extended release [IA-TA-ER]) over 4 months, analyzing their effects on sleep disturbance, a component of health-related quality of life. Methods: All patients with knee OA and received nonoperative interventions with at least 4 months of follow-up between 2021 and 2024 were identified from the Innovations in Genicular Outcomes Research registry, a multicenter novel real-world registry. Patient demographics were gathered/analyzed, adjusting for age, sex, study site, Kellgren-Lawrence grade, baseline score of pain severity/function, pain-catastrophizing, and analgesic use in each assessment. Sleep disturbance was assessed via least-square-means relative to the average population, with multivariate linear regressions used to assess changes pretherapy/post-therapy. Results: Patients administered IA-TA-ER had decreased sleep disturbance relative to other cohorts (least-square-means 52.3; 95% confidence interval: 50.5-54.0; P < .03). Patients receiving IA-TA-ER or IA corticosteroids achieved achieving minimum clinically important difference for sleep disturbance improvement, 63% and 57%, respectively. Pairwise comparison revealed patients receiving IA-TA-ER were 2 times more likely to achieve minimally clinically important difference for improved sleep relative to other cohorts (P < .05). Conclusions: Extended-release triamcinolone injections are associated with decreased sleep disturbance relative to other treatments, in both degree of improvement and proportion of patients. Further studies should examine the potential beneficial effects of IA-TA-ER on other aspects of health-related quality of life.
format Article
id doaj-art-e6afafd0718d487cb9231d7c6edc85a4
institution DOAJ
issn 2352-3441
language English
publishDate 2025-04-01
publisher Elsevier
record_format Article
series Arthroplasty Today
spelling doaj-art-e6afafd0718d487cb9231d7c6edc85a42025-08-20T03:03:08ZengElsevierArthroplasty Today2352-34412025-04-013210165510.1016/j.artd.2025.101655Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World RegistryMichael A. Mont, MD0Jennifer H. Lin, PhD1Andrew I. Spitzer, MD2Vinod Dasa, MD3Adam Rivadeneyra, MD4David Rogenmoser, DO5Andrew L. Concoff, MD6Mitchell K. Ng, MD7Mary DiGiorgi, PhD, MPH8Stan DySart, MD9Joshua Urban, MD10William M. Mihalko, MD, PhD11Sinai Hospital of Baltimore, Baltimore, MD, USA; Corresponding author. Sinai Hospital of Baltimore, The Rubin Institute for Advanced Orthopedics, Department of Orthopaedic Surgery, 2401 W Belvedere Ave 2nd floor, Baltimore, MD 21215, USA. Tel.: +1 410 978 5782.Pacira BioSciences, Inc, Tampa, FL, USACedars Sinai Medical Center, Los Angeles, CA, USALouisiana State University Health Services Center, New Orleans, LA, USAOrthopaedic Specialty Institute, Orange, CA, USAMid State Orthopaedic &amp; Sports Medicine Center, Alexandria, LA, USAExagen Inc., Vista, CA, USAMaimonides Medical Center, Brooklyn, NY, USAPacira BioSciences, Inc, Tampa, FL, USAPacira BioSciences, Inc, Tampa, FL, USAOrthoNebraska, Omaha, NE, USAUniversity of Tennessee Health Science Center, Campbell Clinic Orthopaedics, Memphis, TN, USABackground: Since the mid-20th century, knee osteoarthritis (OA) has doubled in prevalence, costing more than $27 billion annually. This study aimed to compare 6 nonoperative treatment options for knee OA (cryoneurolysis with superficial nerve block, cryoneurolysis with deep nerve block, intra-articular hyaluronic acid injections, nonsteroidal inflammatory drug injections, IA corticosteroids, and IA triamcinolone extended release [IA-TA-ER]) over 4 months, analyzing their effects on sleep disturbance, a component of health-related quality of life. Methods: All patients with knee OA and received nonoperative interventions with at least 4 months of follow-up between 2021 and 2024 were identified from the Innovations in Genicular Outcomes Research registry, a multicenter novel real-world registry. Patient demographics were gathered/analyzed, adjusting for age, sex, study site, Kellgren-Lawrence grade, baseline score of pain severity/function, pain-catastrophizing, and analgesic use in each assessment. Sleep disturbance was assessed via least-square-means relative to the average population, with multivariate linear regressions used to assess changes pretherapy/post-therapy. Results: Patients administered IA-TA-ER had decreased sleep disturbance relative to other cohorts (least-square-means 52.3; 95% confidence interval: 50.5-54.0; P < .03). Patients receiving IA-TA-ER or IA corticosteroids achieved achieving minimum clinically important difference for sleep disturbance improvement, 63% and 57%, respectively. Pairwise comparison revealed patients receiving IA-TA-ER were 2 times more likely to achieve minimally clinically important difference for improved sleep relative to other cohorts (P < .05). Conclusions: Extended-release triamcinolone injections are associated with decreased sleep disturbance relative to other treatments, in both degree of improvement and proportion of patients. Further studies should examine the potential beneficial effects of IA-TA-ER on other aspects of health-related quality of life.http://www.sciencedirect.com/science/article/pii/S2352344125000421Sleep disturbanceTriamcinolone acetonide extended-releaseKnee osteoarthritisReal-world registryCryoneurolysis
spellingShingle Michael A. Mont, MD
Jennifer H. Lin, PhD
Andrew I. Spitzer, MD
Vinod Dasa, MD
Adam Rivadeneyra, MD
David Rogenmoser, DO
Andrew L. Concoff, MD
Mitchell K. Ng, MD
Mary DiGiorgi, PhD, MPH
Stan DySart, MD
Joshua Urban, MD
William M. Mihalko, MD, PhD
Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World Registry
Arthroplasty Today
Sleep disturbance
Triamcinolone acetonide extended-release
Knee osteoarthritis
Real-world registry
Cryoneurolysis
title Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World Registry
title_full Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World Registry
title_fullStr Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World Registry
title_full_unstemmed Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World Registry
title_short Improved Sleep Associated With Triamcinolone Acetonide Extended-Release Injections for Knee Osteoarthritis: Use of a New Real-World Registry
title_sort improved sleep associated with triamcinolone acetonide extended release injections for knee osteoarthritis use of a new real world registry
topic Sleep disturbance
Triamcinolone acetonide extended-release
Knee osteoarthritis
Real-world registry
Cryoneurolysis
url http://www.sciencedirect.com/science/article/pii/S2352344125000421
work_keys_str_mv AT michaelamontmd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT jenniferhlinphd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT andrewispitzermd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT vinoddasamd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT adamrivadeneyramd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT davidrogenmoserdo improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT andrewlconcoffmd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT mitchellkngmd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT marydigiorgiphdmph improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT standysartmd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT joshuaurbanmd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry
AT williammmihalkomdphd improvedsleepassociatedwithtriamcinoloneacetonideextendedreleaseinjectionsforkneeosteoarthritisuseofanewrealworldregistry