Triamcinolone Hexacetonide in the Treatment of Therapy-Refractory Gonitis

Abstract

Thirty-seven patients suffering from sustained gonitis with recurrent hydrops, not satisfactorily controlled by systemic treatment, participated in the study. Twenty-three patients had bilateral and fourteen patients had unilateral gonitis. Controls were obtained through the use of the contra-lateral knee joint in the twenty-three patients with bilateral gonitis. A total of 60 knees were randomized into three groups of 20 knees and received either 30 mg triamcinolone hexacetonide (TH), 60 mg methylprednisolone (MP) or 9 mg betamethasone (BM). The clinical parameters evaluated were: recurrence of hydrops, pain, local tenderness, range of joint movement and joint circumference. The period of time elapsing between the injection and the need for a new injection or other treatment was used as the criterion for the duration of effect. Relief lasting for an average of 176 days was obtained in the 20 knees treated with local injections of TH, compared to 125 days for MP and 79 days for BM. No general or local adverse effects were noted in the patients studied. The observed long duration of effect and the absence of adverse effects justify the use of TH in cases of therapy-refractory gonitis.