DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20191794

Is intra articular injection of triamcinolone acetonide a better option in management for primary osteoarthritis knee than methylprednisolone acetate?

Syam Nath S. H., Ganesan G. Ram

Abstract


Background: Intra articular corticosteroid injections are commonly using in management of osteroarthritis of knee. Most commonly used ones are methylprednisolone acetate (MPA) and triamcinolone acetonide (TA). The aim of our study is to compare the efficacy of these two agents in treating osteoarthritis of knee and find out if any one agent is superior to other if so.

Methods: Selected patients with symptomatic OA knee with kellgren-Lawrence grade III were given intra articular steroid injections (40 mg TA or 40 mg MPA) and were reassessed on day 0, 1 month, 3 months and 6 months. VAS and Knee society scores were calculated using questionnaire method and compared the scores.

Results: The VAS and KSS was improved significantly on day 0,1 month and 6th month and it was found to be increased at 6th month in both the groups and the values were comparable in both the groups. The effect of both the agents last for 3-6 months and the effects found to be maximum at 1st month and the effects starts to wean off at the end of 6 months in both the groups.

Conclusions: Both methylprednisolone acetate (MPA) and triamcinolone acetonide (TA) are equally effective in reducing pain in patients with osteoarthritis of knee and thereby improving their functional ability upto 6 months.


Keywords


Osteoarthritis, Knee, Injection, Intra-articular, Corticosteroid, Methylprednisolone acetate, Triamcinolone acetonide

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References


Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis & Rheumatism. 2008;58(1):26-35.

Neugebauer V, Han JS, Adwanikar H, Fu Y, Ji G. Techniques for assessing knee joint pain in arthritis. Molecular pain. 2007;3(1):8.

Loeser RF. Age-related changes in the musculoskeletal system and the development of osteoarthritis. Clin Geriatr Med. 2010;26(3):371-86.

Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69.

Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Care Res. 2008;59(9):1207-13.

Lomonte AB, de Morais MG, de Carvalho LO, de Freita Zerbini CA. Efficacy of triamcinolone hexacetonide versus methylprednisolone acetate intraarticular injections in knee osteoarthritis: a randomized, double-blinded, 24-week study. J Rheumatol. 2015:150297.

Jinks C, Jordan K, Croft P. Osteoarthritis as a public health problem: the impact of developing knee pain on physical function in adults living in the community: (KNEST 3). Rheumatology. 2007;46(5):877-81.

Uthman I, Raynauld JP, Haraoui B. Intra-articular therapy in osteoarthritis. Postgraduate Med J. 2003;79(934):449-53.

Habib GS, Saliba W, Nashashibi M. Local effects of intra-articular corticosteroids. Clin Rheumatol. 2010;29(4):347-56.

Anandacoomarasamy A, March L. Current evidence for osteoarthritis treatments. Therap Adv Musculoskeletal Dis. 2010;2(1):17-28.

Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2012;64(4):465-74.

Miller JH, White J, Norton TH. The value of intra-articular injections in osteoarthritis of the knee. The Journal of bone and joint surgery. British Vol. 1958;40(4):636-43.

Friedman DM, Moore ME. The efficacy of intraarticular steroids in osteoarthritis: a double-blind study. J Rheumatol. 1980;7(6):850-6.

Dieppe PA, Sathapatayavongs B, Jones HE, Bacon PA, Ring EF. Intra-articular steroids in osteoarthritis. Rheumatology. 1980;19(4):212-7.

Papacrhistou G, Anagnostou S, Katsorhis T. The effect of intraarticular hydrocortisone injection on the articular cartilage of rabbits. Acta Orthopaedica Scandinavica. 1997;68(sup275):132-4.

Pelletier JP, Mineau F, Raynauld JP, Woessner Jr JF, Gunja‐Smith Z, Martel‐Pelletier J. Intraarticular injections with methylprednisolone acetate reduce osteoarthritic lesions in parallel with chondrocyte stromelysin synthesis in experimental osteoarthritis. Arthritis Rheumatism: J Am Coll Rheumatol. 1994;37(3):414-23.

Uthman I, Raynauld JP, Haraoui B. Intra-articular therapy in osteoarthritis. Postgraduate Med J. 2003;79(934):449-53.

Habib GS, Saliba W, Nashashibi M. Local effects of intra-articular corticosteroids. Clin Rheumatol. 2010;29(4):347-56.

Zulian F, Martini G, Gobber D, Agosto C, Gigante C, Zacchello F. Comparison of intra-articular triamcinolone hexacetonide and triamcinolone acetonide in oligoarticular juvenile idiopathic arthritis. Rheumatology. 2003;42(10):1254-9.

Eberhard BA, Sison MC, Gottlieb BS, Ilowite NT. Comparison of the intraarticular effectiveness of triamcinolone hexacetonide and triamcinolone acetonide in treatment of juvenile rheumatoid arthritis. J Rheumatol. 2004;31(12):2507-12.

Pyne D, Ioannou Y, Mootoo R, Bhanji A. Intra-articular steroids in knee osteoarthritis: a comparative study of triamcinolone hexacetonide and methylprednisolone acetate. Clin Rheumatol. 2004;23(2):116-20.

Shikhar, Pandey JK, Narayan A, Ramneek M. A Prospective Clinical Evaluation between Intra - Articular Injections of Methyl Prednisolone and Triamcinolone in Osteoarthritis of Knee Based On the Efficacy, Duration and Safety. Int J Curr Microbiol App Sci. 2013;2(10):369-81.

Jain P, Jain SK. Comparison of efficacy of methylprednisolone and triamcinolone in osteoarthritis of the knee: A prospective, randomized, double-blind study. Int J Sci Study. 2015;3:58-62.

Buyuk AF, Kilinc E, Camurcu IY, Camur S, Ucpunar H, Kara A. Compared efficacy of intra-articular injection of methylprednisolone and triamcinolone. Acta Ortopedica Brasileira. 2017;25(5):206-8.