Compared Efficacy of Intra-Articular Injection of Methylprednisolone and Triamcinolone

Abstract

Objective:To compare the effect of two different corticosteroid types in bilateral and symmetrical knee osteoarthritis (OA). Methods:One hundred and twenty-six patients received injections of methylprednisolone acetate (MP) in one knee and triamcinolone hexacetonide (TH) in the contralateral knee. Patients were evaluated before injection and 2, 4, 8, 12, and 24 weeks after. Results:Mean patient age was 68.5±9 years. Mean BMI was 26.3±2.6 kg/m2. At first admission, mean VAS score was 7.7±1.3 for the right side and 7.5±1.5 for the left side, and mean WOMAC score was 67.6±14.4. After bilateral intra-articular injection, VAS scores for both knees and WOMAC scores decreased significantly when initial scores were compared with 2, 4, 8, 12, and 24 weeks after injection (p<0.05). A statistically significant change was seen over time when VAS and WOMAC scores for 2, 4, 8, 12, and 24 weeks post-injection were compared to each other (p<0.05). No significant difference was seen between knee sides (p>0.05). Conclusion:MP and TH have similar efficacy in relieving pain and improving function. The efficacy of intra-articular corticosteroid injection peaks 2 weeks after injection and the effect continues until the 24th week. Level of Evidence II, Comparative Prospective Study.

Knee osteoarthritis: pathophysiology and current treatment modalities

“… 36 Pyne et al also suggested that TA acts quicker and provides better pain relief for the first 3 weeks than MA, but the effect of the latter might not start immediately, thus it might provide better analgesia after the eighth week. 37 A recent comparative study by Buyuk et al showed that both MA and TH were equally effective until week 24th with a peak of action by the second week, 34 confirming similar findings by Lomonte et al 38 …”

“…A portion of the IA CS is absorbed systemically, with the possibility to produce hypoglycemia and transiently affect the hypothalamic-pituitary-adrenal (HPA) axis in up to 25% of the patients. 34 , 53 Cortisol levels might decrease after injection, but they return to baseline after 1–4 weeks. 34 , 53 …”

“… 34 , 53 Cortisol levels might decrease after injection, but they return to baseline after 1–4 weeks. 34 , 53 …”

Comparison Between Efficacy of Methylprednisolone and Triamcinolone in Intra Articular Injection for Osteoarthritis Pain Relief

“…While in study Yavuz et al 17 reported that methylprednisolone is more effective as compared to triamcenolone when their efficacy was compared in intra articular injection for relief of osteoarthritis pain until 6 weeks of injection administration. In a study conducted by Buyuk AF et al 8 reported that there is no difference in effectiveness of both corticosteroids regimens in knee pain relief.…”

“…Results of this corticosteroid injection are not consistent, short term benefits also reported in literature (about four weeks). On other hand some studies on this topic reported 24 weeks effect 8 . Some clinical trials on comparison of different corticosteroids are also available for intra articular injection 9 .…”