Joint lavage associated with triamcinolone hexacetonide injection in knee osteoarthritis: a randomized double-blind controlled study

Abstract

Compare the medium-term effectiveness and tolerance between joint lavage (JL) in combination with triamcinolone hexacetonide (TH) intra-articular injection (IAI) and IAI with TH alone for treatment of primary osteoarthritis (OA) of the knee. A randomized, double-blind, controlled study was carried out on 60 patients with primary OA of the knee, randomized into two intervention groups: JL/TH group, joint lavage in combination with TH intra-articular injection and TH group, TH intra-articular injection. Patients were followed for 12 weeks by a blind observer using the following outcome measurements: visual analogue scale for pain at rest and in movement, goniometry, WOMAC, Lequesne's index, timed 50-ft walk, perception of improvement, Likert scale for improvement assessment, use of nonsteroidal anti-inflammatory drugs and analgesics, and local side effects. There were no statistical differences in the inter-group analysis for any of the variables studied over the 12-week period. Although both groups demonstrated statistical improvement in the intra-group evaluation (except for Likert scale according to patient and the use of anti-inflammatory drugs). In the Kellgren-Lawrence scale (KL) 2 and 3 sub-analysis, there was a statistical difference regarding joint flexion among patients classified as KL 2, favoring the TH group (p=0.03). For the KL 3 patients, there were statistical differences favoring the JL/TH group regarding Lequesne (p=0.021), WOMAC pain score (p=0.01), and Likert scale according to the patient (p=0.028) and the physician (p=0.034). The combination of joint lavage and IAI with TH was not more effective than IAI with TH alone in the treatment of primary OA of the knee. However, KL 3 patients may receive a major benefit from this combination.

Safety and Efficacy of Aceclofenac in Osteoarthritis Patients

“…The outcome of the therapy was based on the improvement of the clinical manifestations of osteoarthritis and tolerability of the drug. Clinical Assessments: Clinical assessment was done by calculating WOMAC scores 29 , time taken to walk a distance of 100 feet, Visual Analogue Scale Scores 30 for pain, investigator's assessment on a LIKERT scale 31 and joint tenderness. Tolerability assessment was based on adverse events as well as compliance.…”

Intra-articular injections of triamcinolone hexacetonide in rheumatoid arthritis: short and long-term improvement predictors

“…[6][7][8][9][10][11][12][13] On the other hand, if injected outside of the joint, it can cause serious adverse local effects. 14 Though some concepts concerning IAIC have been established, few studies have been conducted to evaluate response predictors in adult RA patients.…”

Comparative Study of Safety, Efficacy, and Tolerability of Aceclofenac Versus Diclofenac in Osteoarthritis Patients.

“…Patients received Aceclofenac 100 mg twice daily & Diclofenac 75 mg twice daily were administered orally for 3 months. Clinical Assessments: Clinical assessment was done by calculating WOMAC scores 29 , time taken to walk a distance of 100 feet, Visual Analogue Scale Scores 30 for pain, investigator's assessment on a LIKERT scale 31 and joint tenderness. Tolerability assessment was based on adverse events as well as compliance.…”