Efficacy of Ultrasonography-Guided Compared to Surface Landmark-Based Corticosteroid Injection for People with Chronic Pes Anserine Tendinitis or Bursitis: a Randomised Controlled Trial

Background/Aims One of the main aetiologies of patients' symptoms who have degenerative knee disease is pes anserine tendinitis or bursitis. Local corticosteroid injection is an effective treatment for chronic cases. The aim of this study was to compare the efficacy of an ultrasonography-guided corticsosteroid injection vs a landmark-based injection. Methods A total of 31 patients with clinical chronic (>3 months) pes anserine tendinitis bursitis, confirmed by ultrasonography, were randomised into two groups. One group received a corticosteroid injection (40 mg triamcinolone acetonide) with ultrasonographic guidance, and the other group received a corticosteroid injection without ultrasonographic guidance. Participants and the assessor were blind to the type of procedure. Participants were clinically assessed using the Western Ontario and McMaster University knee questionnaire before and 2 weeks after the injection and a visual analogue scale before, 2 and 12 weeks after the injection. Results There were significant decreases for both groups in the visual analogue scale at 2 weeks and 12 weeks after the injection, with a superior decline in the ultrasound-guided group (mean difference: 60.00, P<0.001 in ultrasound-guided group, and mean difference: 25.33, P<0.022 in the surface landmark-based group). The Western Ontario and McMaster University questionnaire scores also demonstrated significant improvement in both groups, with no preferential difference between groups (mean difference: 26.87, P<0.001 in the ultrasound-guided group, and mean difference: 22.20, P<0.001 in the surface landmark-based group). Conclusions Steroid injection is an effective treatment to manage chronic pes anserine bursitis, and ultrasonography guidance may further improve clinical outcomes.