Outcome of intra-articular corticosteroid vs. intra-articular ketorolac in symptomatic knee osteo-arthritis: a retrospective study

Abstract

Background: Main target of treatment of osteoarthritis is improvement of pain relief and functional impairment. Intra-articular triamcinolone injections are most common treatment approach in India in the non-operative management of painful osteoarthritis knee. Corticosteroids can significantly reduce local inflammatory reactions but have side effects like cartilage toxicity and increase risk of local infection. Nonsteroidal anti-inflammatory drugs have been considered as an alternative in intra-articular injections for analgesia. They have strong anti-inflammatory effects and fewer adverse reactions as compared with triamcinolone injections. The primary aim of this study was to compare the outcome of patients with symptomatic knee osteo-arthritis receiving either an intra-articular ketorolac or corticosteroid injection.Methods: Our study is case-control, retrospective comparative study, a total of 50 patients with symptomatic knee osteo-arthritis, All patients received 4, weekly injection. triamcinolone or ketorolac for first three weeks and on 4th week only intra-articular sodium hyaluronate injections. All the parameters (VAS, WOMAC) were evaluated and recorded at 1st, 2nd, 5th weeks and 3 months after first injection.Results: At the first week, the VAS score was lower in group A, but no significant differences were found at any other time point as per WOMAC score and VAS score. And there was insignificant difference in group 1 and 2 scores.Conclusions: Both intra-articular injections regimen showed nearly same efficacy with clinically insignificant difference, ketorolac intra-articular injection can alleviate steroid’s side effects.