An Open Randomized Trial Comparing the Effects of Oral NSAIDs Versus Steroid Intra-Articular Infiltration in Congestive Osteoarthritis of the Knee.

OBJECTIVE: To compare the efficacy on pain and joint function of NSAIDs versus steroid intra-articular infiltration in congestive knee osteoarthritis.

PATIENTS AND METHODS: Open randomized study comparing a series of patients treated with NSAIDs for 21 days and another who received steroid intra-articular infiltration (SIAI) spaced at every 7 days. The visual analog scale was used for the weekly assessment of spontaneous pain and pain when walking. Lequesne functional pain scale was used to assess the functional impact of knee osteoarthritis.

RESULTS: Seventy patients were enrolled, including 35 in the NSAID arm and 35 in SIAI arm. Forty-nine (70%) had stage III of Kellgren and Lawrance scale. On admission, the average pain intensity was 50.46 ± 30.93 in the NSAID arm and 60.92 ± 30 in SIAI arm (p = 0.0189). At the end of follow-up, pain intensity was 6.72 ± 13 in NSAIDs patients and 17.80 ± 21 in SIAI one (p = 0.001). The average intensity of pain on walking was 64.41 ± 22.61. It was 53.33 ± 22.31 in NSAID's against 74.85 ± 17.55 in SIAI patients (P <0.0001). At the end of the treatment, they were respectively 19.11 ± 11.37, and 35 ± 30.69 (P = 0.0085).

CONCLUSION: Corticosteroid injections have a short efficacy compared to NSAIDs. Prescribing NSAIDs should consider the cons-indications, comorbidities and their deleterious digestive, renal, and cardiovascular effect.