Hichem Khenioui
Physical Medicine and Rehabilitation, Hospital Saint-Philibert, Hospital Group in Lille Catholic Institute, Lomme Cedex, France
Title: Usefulness of intra-articular Botulinum toxin injections: A literature review
Biography
Biography: Hichem Khenioui
Abstract
Background: 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 con-trolled 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.