Prospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2025; 16(2): 101197
Published online Feb 18, 2025. doi: 10.5312/wjo.v16.i2.101197
Pre-injection local anesthesia does not affect experienced pain in intra-articular hip injections
Assaf Albagli, Ehud Rath, Ido Druckmann, Ben Efrima, Efi Kazum, Nata Parnes, Alexis B Sandler, John Tyler, Eyal Amar
Assaf Albagli, Ben Efrima, Efi Kazum, Department of Orthopedic, Tel Aviv Medical Center, Tel Aviv-Yafo 6801298, Tel Aviv, Israel
Ehud Rath, Eyal Amar, Department of Orthopedic, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
Ido Druckmann, Department of Radiology, Tel Aviv Medical Center, Tel Aviv-Yafo 6801298, Tel Aviv, Israel
Ido Druckmann, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo 6801298, Tel Aviv, Israel
Nata Parnes, John Tyler, Department of Orthopedic Surgery, Carthage Area Hospital, Carthage, NY 13619, United States
Alexis B Sandler, Department of Orthopedic Surgery, Texas Tech University Health Sciences-El Paso, El Paso, TX 79905, United States
John Tyler, Department of Orthopedic Surgery, Loyola University Chicago Stritch School of Medicine, Maywood, IL 60153, United States
Eyal Amar, Department of Orthopedic, Tel Aviv University, Tel Aviv 62308, Israel
Author contributions: Albagli A and Amar E conceived and designed the research study; Albagli A, Rath E, Druckmann I, Efrima B, Kazum E, and Amar E performed the research; Albagli A, Rath E, Druckmann I, Efrima B, Kazum E, Sandler AB, Parnes N, Tyler J, and Amar E wrote and edited the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: his study was approved by the Medical Ethics Committee of the Tel Aviv Sourasky Medical Center Institutional Review Board, approval No. TLV-0674-21.
Clinical trial registration statement: This study was submitted for registration at ClinicalTrials.gov on December 16, 2024.
Informed consent statement: All study participants or their legal guardians provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Statistical code and dataset available upon reasonable request from the corresponding author at jtyler@luc.edu. Consent was not obtained but the presented data are anonymized; therefore, the risk of identification is low.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: John Tyler, Department of Orthopedic Surgery, Carthage Area Hospital, 2160 Street 1st Avenue, Carthage, NY 13619, United States. johntyler861@gmail.com
Received: September 12, 2024
Revised: January 2, 2025
Accepted: January 17, 2025
Published online: February 18, 2025
Processing time: 153 Days and 5 Hours
Abstract
BACKGROUND

Intra-articular hip injections (IAHIs) are commonly used for diagnostic and therapeutic purposes but are often associated with patient anxiety and fear. The disparity between anticipated and experienced pain during IAHIs and the role of pre-injection local anesthesia in pain modulation remains unclear.

AIM

To investigate the difference between anticipated and experienced pain during IAHIs and the impact of pre-injection local anesthesia.

METHODS

This prospective study enrolled 60 patients undergoing IAHI, 30 receiving pre-injection superficial local anesthesia and 30 serving as a control group without pre-injection local anesthesia. Pain levels were assessed using numeric rating scales.

RESULTS

Patients significantly overestimated anticipated pain compared to experienced pain (6.43 ± 2.48 vs 3.68 ± 2.37, P < 0.001). Pre-injection local anesthesia did not significantly reduce experienced pain (3.19 ± 2.38 vs 4.20 ± 2.29, P = 0.130).

CONCLUSION

Patients overestimate anticipated pain during IAHIs. Pre-injection local anesthesia does not reduce experienced pain.

Keywords: Hip; Injection; Patient experience; Pain; Practice management

Core Tip: This study evaluated anticipated vs experienced pain during intra-articular hip injections (IAHIs) in 60 prospectively recruited patients, with or without pre-injection local anesthesia. Anticipated pain was significantly overestimated compared to experienced pain, and pre-injection local anesthesia did not affect the experienced pain. These results suggest that the hip joint capsule may significantly contribute to nociception during IAHI, more so than the superficial soft tissues along the needle trajectory. Ultimately, these findings provide valuable insight into the pain experienced during IAHI and may help improve patient experiences.