Comparison of intra-articular cortisone analogues in osteo-arthritis of the knee.

The use of intra-articular steroids in the treatment of osteo-arthritis of the knee joints has not been much discussed in the literature. Burgess (1957) states that intra-articular hydrocortone is of most value in joints distended by synovial fluid. Williams (1958) found that hydrocortisone tertiarybutylacetate was effective over a longer period than hydrocortisone, but that both might dramatically relieve symptoms, especially pain, for anything from 2 weeks to several months. Zuckner, Machek, and Ahern (1956) compared the effects of intra-articular hydrocortisone acetate and hydrocortisone tertiarybutylacetate in a number of rheumatic joints, including the knee. They found no significant difference between the two compounds, but stated that 80 per cent. of joints so treated, whether rheumatoid or osteo-arthritic, responded for periods varying from 3 weeks to several months. Hollander and Moore (1956), who studied the intra-articular temperature response to injection of hydrocortisone acetate and prednisone, found that osteo-arthritic joints had a higher temperature than the normal, and that the temperature rose after intra-articular injection. Most of their patients obtained partial or complete relief for a varying period after the injections. Miller, White, and Norton (1958) injected various substances into osteo-arthritic knees, including hydrocortisone, without notable effect. The purpose of the present investigation is two-fold: (i) To compare three of these preparations; (ii) To determine the value of intra-articular steroids in osteo-arthritis of the knees.