A COMPARATIVE EVALUATION OF INTRA-ARTICULAR TRIAMCINOLONE ACETONIDE VERSUS METHYLPREDNISOLONE ACETATE FOR KNEE OSTEOARTHRITIS
Keywords:
Knee osteoarthritis, Intra-articular injection, Methylprednisolone acetate, Triamcinolone acetonide, Pain, Function, Corticosteroid.Abstract
Background: Knee osteoarthritis (KOA) is a leading cause of pain and disability worldwide. Intra-articular corticosteroids, including triamcinolone acetonide (TAC) and methylprednisolone acetate (MPA), are widely used for short-term symptomatic relief, but their comparative effectiveness remains unclear.
Objective: To comparatively evaluate the clinical efficacy, pain reduction, functional improvement, and short-term safety of intra-articular TAC versus MPA in patients with symptomatic knee osteoarthritis.
Methods: A comparative cross-sectional study was conducted over four months at two clinical centers in Khyber Pakhtunkhwa, Pakistan. A total of 126 adults aged 40–75 years with clinically and radiologically confirmed KOA (Kellgren–Lawrence Grades I–III) were enrolled and allocated to receive either intra-articular TAC (n=63) or MPA (n=63). Pain was assessed using the Visual Analog Scale (VAS), and function was evaluated using a six-item WOMAC/function score. Assessments were performed at baseline and at a single post-injection follow-up. Between-group differences were analyzed using Mann–Whitney U tests and multiple linear regression to adjust for baseline imbalances.
Results: Both treatment groups demonstrated significant improvement in pain and function. However, MPA was associated with significantly greater VAS improvement (mean 4.508 vs 1.937; U=178.000, Z=−8.960, p<0.001; r≈0.80) and greater improvement in the six-item WOMAC/function score (mean 10.206 vs 5.984; U=215.000, Z=−8.688, p<0.001; r≈0.77). Patient satisfaction, willingness to recommend treatment, and quality-of-life improvement were also significantly higher in the MPA group (all p<0.001). Local adverse events were infrequent and similar between groups; systemic effects (headache) were reported only in the TAC group (p=0.012).
Conclusion: Intra-articular MPA provides superior short-term pain relief and functional improvement compared with TAC in patients with mild-to-moderate knee osteoarthritis. Both injections appear safe in the short term. These findings support the use of MPA when rapid symptomatic control is the primary treatment goal, although longer-term randomized trials are needed to confirm durability and safety.
