A Comparison between the Efficacy of Intra-articular Injections of Ketorolac and Triamcinolone in Patients with Knee Osteoarthritis

Osteoarthritis (OA) is one of the main causes of chronic pain in worldwide. Intra-articular corticosteroid injection has been routinely used for symptom control in patients with osteoarthritis. Some possible complications have limited its repeated application. Recently, intra-articular injection of nonsteroidal anti-inflammatory drugs (NSAIDs), namely ketorolac, has drawn major attention which should be further assessed.
In this double-blind clinical trial study, 38 patients randomly assigned into two equal groups of case with single intra-articular injection of 30 mg ketorolac and control with single intra-articular injection of 40 mg triamcinolone. Required data were gathered via visual analogue scale (VAS), and validated Persian translations of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Lequesne questionnaires.
Findings: In one and three months follow up, triamcinolone was effective in pain reduction, joint stiffness, function, and walking ability. Ketorolac was effective only in the pain domain of questionnaires. In One month, triamcinolone showed a considerably better pain reduction effect than ketorolac (P = 0.008). However, after 3 months, both methods were equally effective in pain reduction (P = 0.712).
Ketorolac can cause significant pain reduction in knee osteoarthritis, but considering its minimal effects on patients’ functional status, its application should be limited to cases with contraindications or patient refusal to corticosteroid injection.