Comparison of intra-articular steroid injection with combined oral steroid and intra-articular steroid injection to treat patients with knee osteoarthritis

Objective: To evaluate the benefits provided by a short course of low dose oral Prednisolone followed by intra-articular injection of Methylprednisolone to treat osteoarthritis Knee as compared to intra-articular injection of Methylprednisolone and placebo. Study Design: Quasi-experimental study Place and Duration of Study: Department of Rehabilitation Medicine, Combined Military Hospital Quetta, Pakistan from Aug to Nov 2023. Methodology: Ninety nine patients with OA of Knee joint were randomly assigned to 3 groups, Group-A received a short course (14 days) of low dose oral steroids (15 mg Prednisolone ) followed by one intra-articular steroid injection (administered two weeks later). Patients in Group-B received intra-articular injection of steroid only and Group-C received intra-articular injection of normal saline. All patients were evaluated using the Western Ontario and McMaster Universities (WOMAC) & Visual Analogue Scale (VAS) score before the treatment and at 2,6,12 and 16 weeks following treatment. Result: There were significant improvements in both Group-A & Group-B. Particularly, patients in Group-A had significantly superior VAS and WOMAC scores than were seen in groups B and C. The VAS and WOMAC scores remained the same as were pre-treatment in group C. Group-A and B both showed improvement but to different extent with superior results in Group-A till 16 weeks. Conclusion: The combination of short course of low dose oral steroids with intra-articular steroid injections resulted in significantly superior symptomatic improvement, with sustained lower VAS and WOMAC scores, hence improving quality of life for 16 weeks.