Osteoarthritis, Knee
Conditions
Keywords
Knee Osteoarthritis, Intra-articular Injection, Tenoxicam, Non-Steroidal Anti-Inflammatory Drugs, Triamcinolone Acetonide, Corticosteroid Injections, Pain Management
Brief summary
Knee osteoarthritis is a very common joint condition that leads to pain, stiffness, and difficulty with daily activities, particularly in middle-aged and older adults. Many patients do not get adequate relief from oral pain medications, non-steroidal anti-inflammatory drugs, or physical therapy. Because of this, injections directly into the knee joint are often used. Corticosteroid medicines, such as triamcinolone acetonide, are among the most frequently used intra-articular injections. They provide strong and rapid anti-inflammatory effects, but their benefits often wear off after only a few weeks. In addition, corticosteroids may cause unwanted systemic effects such as temporary increases in blood sugar, which can be especially concerning for patients with diabetes. Non-steroidal anti-inflammatory drugs are another group of medicines that can relieve pain and inflammation. Tenoxicam is a long-acting medicine from this group. When given directly into the knee joint, tenoxicam may provide local pain relief for a longer duration, while reducing the amount of drug that circulates in the body. This may lower the risk of side effects compared with oral treatment or repeated corticosteroid injections. This clinical study was designed to compare the effects of a single intra-articular injection of tenoxicam with a single intra-articular injection of triamcinolone acetonide in patients who have symptomatic knee osteoarthritis. The primary aim was to determine which treatment provides better improvement in knee pain, measured using a visual analog scale. Secondary aims included evaluating knee function using the Western Ontario and McMaster Universities Osteoarthritis Index, monitoring blood sugar control using glycated hemoglobin testing, and assessing the safety of each treatment by recording any local or general adverse events.
Interventions
DRUGTenoxicam
Intra-articular administration of tenoxicam, 20 milligrams as a single injection, delivered through an anterolateral approach under aseptic technique.
DRUGTriamcinolone Acetonide
Intra-articular administration of triamcinolone acetonide, 40 milligrams as a single injection, delivered through an anterolateral approach under aseptic technique.
Sponsors
Benha University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
This was an open-label trial. Participants and investigators were aware of treatment allocation.
Intervention model description
Participants were randomly assigned in a 1:1 ratio to receive either intra-articular tenoxicam or intra-articular triamcinolone acetonide.
Eligibility
Sex/Gender
ALL
Age
45 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 45 to 75 years * Radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade II-III) * Persistent knee pain for at least 3 months despite oral non-steroidal anti-inflammatory drugs * Ability to provide informed consent
Exclusion criteria
* Prior intra-articular injection within the past 6 months * Inflammatory arthritis (e.g., rheumatoid arthritis, gout) * Advanced knee osteoarthritis (Kellgren-Lawrence grade IV) * Active joint or systemic infection * Bleeding disorder or anticoagulant use contraindicating injection * Uncontrolled diabetes mellitus * Known hypersensitivity to tenoxicam or triamcinolone acetonide
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Knee Pain Intensity Measured by Visual Analog Scale | Baseline, 2 weeks, 6 weeks, and 12 weeks after injection | Pain intensity in the affected knee was assessed using a visual analog scale (0 to 100 millimeters), where 0 represents no pain and 100 represents the worst imaginable pain. The outcome was defined as the change from baseline score to follow-up assessments. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Knee Function Measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) | Baseline, 2 weeks, 6 weeks, and 12 weeks after injection | The Western Ontario and McMaster Universities Osteoarthritis Index evaluates pain, stiffness, and physical function in patients with knee osteoarthritis. Scores range from 0 to 96, with higher scores indicating worse symptoms. The outcome was defined as the change from baseline to follow-up. |
| Change in Glycemic Control Measured by Glycated Hemoglobin (HbA1c) | Baseline and 1 month after injection | Glycated hemoglobin (HbA1c) was measured to evaluate the effect of intra-articular injection on blood glucose control. The outcome was defined as the change in HbA1c percentage from baseline to one month after injection. |
Countries
Egypt
Outcome results
None listed