Abstract
Objective: To compare the effect of two different corticosteroid regimens methylprednisolone acetate and triamcenolone acetate in bilateral and symmetrical knee osteoarthritis (OA) pain relief. Study Design: A Randomize Control Trial. Place And Duration of Study: Department of Anaesthesia, Intensive care and Pain Management Nishtar Hospital, Multan, Bahawal Victoria Hospital and Mayo Hospital, Lahore from 1 November 2017 to 30 October 2018. Methodology: After getting ethical approval from hospital ethical committee and informed consent from patients to be included in study. Total 100 patients were enrolled in study through non probability consecutive sampling technique, and all patients were divided in two equal groups randomly using lottery method. Data was collected on pre designed Performa. Statistical analysis was done by using SPSS version 24 for all variables, mean and SD presentation for continuous data like age and VAS score, WOMAC score and frequency percentage presentation was given for categorical data like gender. P value < 0.05 was considered as significant. Results: Total 100 patients were included, in this study. The mean age and BMI of the patients was 60.33±2.61 years and 27.06±2.42 kg/m 2 respectively. A significant decrease in VAS score for both knees (right and left) was observed after intra articular injection bilaterally. Measurements were done at 2, 4, 8, 12 and 24 weeks after injection administration (p<0.005). Conclusion: Results of our study revealed that intra articular injection is an effective mode of treatment when used for the management of osteoarthritis knee pain (p<0.005). when we compared two steroid regimens Methylprednisolone and Triamcenolone it was observed that there is no significant difference among both groups, both are equally effective. Keywords: Intra-aticular injection, Triamcenolone acetate, Methylprednisolone, Osteoarthritis . DOI : 10.7176/JMPB/62-01 Publication date: December 31 st 2019
Highlights
Knee pain in adult age is more probably due to the osteoarthritis OA, it reduces the quality of life and a continuous disability is the fate of person[1,2]
Some clinical trials on comparison of different corticosteroids are available for intra articular injection[9]
Patients with history of previous intra articular injection, unstable joint, secondary arthritis, diabetes, any malignant cancer, BMI more than 30 and who were contraindicated to injections like presence of infection, on anti coagulant therapy and allergic to drug used were excluded from the study
Summary
Knee pain in adult age is more probably due to the osteoarthritis OA, it reduces the quality of life and a continuous disability is the fate of person[1,2] Main goal of such patients is control of pain with conservative management, exercise, physical therapy, medication and weight loss[3]. Mechanism of action of injection is not yet clear but it is reported that corticosteroids inhibits the release of leukocytes in synovial fluid and prevent the release of prostaglandins and interleukins[5]. Clinical effectiveness of this injection was reported in many studies. Some clinical trials on comparison of different corticosteroids are available for intra articular injection[9]
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