[The role of corticosteriods in knee osteoarthritis with accompanying inflammatory pain]

ABSTRACT

Intraarticular corticostroids [IAC] are recommended in the treatment of knee osteoarthntis [KOA] specially those cases in which there is joint effusion. On the basis of the recent data, their efficacy is limited in relieving pain for a short duration. To investigate the efficacy of IAC in patients with inflammatory pain [IP] of KOA, the present no controlled prospective study was performed. Patients with KOA according to ACR criteria who presented with persistent IP and joint effusion were enrolled in the study. Intraarticular triamcinolone hexacetonide was prescribed after complete joint fluid aspiration. Patients were evaluated for pain [at rest and movement], performance restriction and physical disability at baseline and 4 weeks after IAC treatment using SPSS software by Wilcoxone match pairs signed rank test and Chi-square Mc nemar test. 71 patients [26 females and 45 males] with mean age of 60 +10 years were studied. Persistent IP and joint effusion were detected in 100%, night joint pain in 95%, performance restriction in 75% and physical disability in 80% of patients. Four weeks after treatment the joint pain [Lickert pain score] decreased from 2.9 + 0.9 to 0.96 + 1.2 [PC 0.01], performance restriction [Lequesn's functional index] from 6.4 + 1.9 to 2.2 + 1. 9 [P< 0.0l], and physical disability [WOMAC functional index] from 10. 2 + 2. 6 to 3.3 + 2. 6 [P< 0.01]. At the end of study the proportion of patients with persistent joint pain at night and rest joint effusion performance restriction and physical disability was, 2%; 5%; ?5%; and 45% respectively [P<0.0l]. In patients with IP of KOA, IAC treatment is accompanied by rapid alleviation of pain and physical disability