Adding triamcinolone to viscosupplementation: one year outcome of randomized trial

OBJECTIVE: This is an extended follow-up of a randomized controlled trial to evaluate if the addition of triamcinolone to viscosupplementation could alter one-year pain and function of viscosupplementation alone. This is a Level I Therapeutic study (See Guidelines for Authors for a complete description of levels of evidence). METHODS: In a previously reported study we prospectively enrolled 104 patients with knee osteoarthritis and randomizedthemtoreceiveeithera single intra-articular injection (6mL)ofhylanGF-20 (Groupviscosupplementation [GroupVS]), or a single intra-articular injection of hylanGF-20 (6mL) and 1mL (20mg) of triamcinolone hexacetonide (Group VS þ T). Visual Analogue Scale, WOMAC, and Lequesne questionnaires were completed at baseline, at weeks 1, 4, 12, 24. At the one-year follow-up point, all patients were recruited and reassessed. RESULTS: At one year, the effects of treatment observed in the previous periods were present, with no differences between groups; only the Group receiving hylan þ triamcinolone hexacetonide still showed a difference from baseline in the Visual Analogue Scale questionnaire. CONCLUSIONS: The addition of triamcinolone hexacetonide improves first-week symptoms and functional scores of viscosupplementation and does not alter its adverse effects. There might be benefits for the one-year pain results.