Affiliations: [a] Department of Physical Medicine and Rehabilitation, Myongji Hospital, Kwandong University College of Medicine, Koyang, Kyunggi, Korea | [b] Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea | [c] Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence:
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Address for correspondence: Won Hyuk Chang, MD, Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea. Tel.: +82 2 3410 2818; Fax: +82 2 3410 0052; E-mail: wh.chang@samsung.com, iamchangwh@naver.com
Abstract: Objective:The purpose of this study was to evaluate the efficacy of intra-articular ketorolac to improve intra-articular hyaluronic acid (HA) therapy in knee osteoarthritis with respect to the initiation of pain relief. Methods:This study was designed as a single-blind study with a blinded observer and a 3-month follow-up. Forty-three patients with knee osteoarthritis were randomized to the ketorolac group (n=21) or the HA group (n=22). Ketorolac group members were given three weekly intra-articular injections of HA with ketorolac and then two weekly intra-articular injections of HA; and HA group members were given five weekly intra-articular HA injections. Visual analog scale (VAS), pain rating score (PRS) and adverse events were assessed at baseline and at 1st, 3rd, 5th, and 16th week after treatment commencement. Results:Significant improvement regarding pain assessment tools was observed in the ketorolac group by the addition of ketorolac to HA as compared with the HA group within 16 weeks of follow-up (p < 0.05). In the ketorolac group, 5 of the 21 subjects developed focal post-injection knee pain for about 8 hours after injection. Conclusion:Intra-articular HA with ketorolac showed more rapid analgesic onset than intra-articular HA alone and did not induce any serious complications.
