Abstract
ObjectiveTo evaluate the effect of an intra-articular (IA) administration of triamcinolone hexacetonide, compared with saline.Patients and methodsForty (N = 40) hip joints were randomly assigned to a treatment group (THG, n = 20, receiving IA triamcinolone hexacetonide) and a control group (CG, n = 20, receiving IA saline). On treatment day (T0), and at 8, 15, 30, 90 and 180 days post-treatment, weight distribution, joint range of motion, thigh girth, digital thermography, radiographic signs, synovial fluid interleukin-1 and C-reactive protein levels were evaluated. Data from four Clinical Metrology Instruments was also gathered. Results were compared Repeated Measures ANOVA, with a Huynh-Feldt correction, Paired Samples T-Test or Wilcoxon Signed Ranks Test. A Kaplan-Meier test was performed to compare both groups, with p<0.05.ResultsJoints were graded as mild (65%), moderate (20%) and severe (15%). Patients of both sexes, with a mean age of 6.5±2.4 years and bodyweight of 26.7±5.2kg, were included. No differences were found between groups at T0. Comparing THG to CG, weight distribution showed significant improvements in THG from 8 (p = 0.05) up to 90 days (p = 0.01). THG showed lower values during thermographic evaluation in the Lt view (p<0.01). Pain and function scores also improved from 30 to 180 days. Increasing body weight, age, and presence of caudolateral curvilinear osteophyte corresponded to worse response to treatment. Results of the Kaplan Meier test showed significant differences between groups, with THG performing better considering several evaluations and scores.ConclusionTHG recorded significant improvements in weight-bearing and in with the considered CMIs, particularly pain scores. Lower thermographic values were registered in THG up to the last evaluation day. Age, sex, and radiographic findings did significantly influenced response to treatment.
Highlights
Osteoarthritis (OA) is a disease transversal to all mammals and a source of chronic pain
Lower thermographic values were registered in THG up to the last evaluation day
By effect is obtained through a dose-dependent reduction in the cartilage proteolytic enzyme stromelysin, interleukin 1β, and the oncogenes c-fos and c-myc, which are involved in the metalloproteinases synthesis [19]
Summary
Osteoarthritis (OA) is a disease transversal to all mammals and a source of chronic pain. The changes that occur in slowly progressive spontaneous dog OA closely match those of human OA, while maintaining the same life stages that go by at a faster progression rate, and sharing many of the same environmental conditions. For those reasons, the naturally occurring canine model is considered the closest to a gold standard [6,7,8,9,10,11]. A human systematic review has deemed triamcinolone more effective than betamethasone and methylprednisolone [15]. The mean duration of effect of TH in patients with OA is around seven months [20]
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