Hydrocortisone in Minor Orthopædic Conditions

DISILLUSIONMENT and disappointment frequently follow the initial enthusiasm for using a new therapeutic substance. Only prolonged and careful study by many workers reveals the true value and the limitations of a new drug. When Hench and his associates at the Mayo Clinic introduced cortisone for the systemic treatment of rheumatoid arthritis (Hench et. al., 1949) hopes ran high at first, but gradually it was realised that cortisone was no more effective than the humble aspirin tablet in the treatment of this chronic disease (Medical Research Council Report, 1955). Likewise, the local injection of cortisone and hydrocortisone was, at first, reported to produce beneficial results in many arthritic and soft tissue lesions (Hollander et al., 1951; Robecchi and Capra, 1953; Murley, 1954). Later reports, however, suggested that these injections were no more effective than injections of local anaesthetic agents or inert substances (Freeland and Gribble, 1954; Brockley, 1956). In order to help determine whether hydrocortisone was of any real value in orthopadic practice an investigation was carried out to study the effects of this hormone on a wide variety of minor orthopaedic conditions.