Intra-articular therapy in osteo-arthritis; comparison of hydrocortisone acetate and hydrocortisone tertiary-butylacetate.

The intra-articular injection of hydrocortisone acetate is commonly used in the treatment of osteoarthritis, although its action in this disease has received less careful study than in rheumatoid arthritis. In 1955 a less soluble ester, hydrocortisone tertiary-butylacetate (TBA) was developed for intraarticular therapy with the claim that its effects were more pronounced and of longer duration (Hollander, Brown, Jessar, Udell, Smukler, and Bowie, 1955). The purpose of the present trial was to evaluate both drugs in the treatment of osteo-arthritis by a double-blind, crossover method. Each patient received both compounds as well as placebo and thus served as his own control. This formed part of a wider study of the value of intra-articular therapy in rheumatic disease. The results of the present investigation will be compared with those obtained in rheumatoid arthritis (Chandler, Wright, and Hartfall, 1958).