Knee Injection RCT

Efficacy and Cost-effectiveness of Intra-Articular Ketorolac Injection for Knee Osteoarthritis: A Randomized, Controlled, Double-Blinded Study

Hypothesis: Ketorolac injection is a cost-effective adjunct in the nonoperative treatment of knee osteoarthritis (OA) compared to steroids and viscosupplementation.

Aims/objectives: The objective of this randomized, controlled, double-blinded, prospective study is to assess the efficacy and cost-effectiveness of knee injection with ketorolac in the nonsurgical management of symptomatic OA compared to injections with corticosteroids and viscosupplements.

The purpose of this research study is to examine the effectiveness of intra-articular (inside the joint) ketorolac injection compared to injection with either corticosteroid or hyaluronic acid for the treatment of painful knee osteoarthritis. Patients will be randomly assigned to receive either ketorolac (a nonsteroidal anti-inflammatory drug, methylprednisolone (a steroid), hyaluronic acid (a substance that is naturally present in the human body).

Inclusion Criteria:

• Patients over the age of 18 who present with 1) symptomatic knee OA and radiographic evidence of joint space narrowing and 2) are interested in knee injections for pain relief.

Exclusion Criteria:

• Prior injections into the same knee within the past 6 months,
• Pregnant and/or lactating women,
• Inflammatory joint disease including rheumatoid or psoriatic arthritis,
• Concurrent use of anti-rheumatic drugs,
• Allergy or hypersensitivity to the study medications,
• Patients on an active pain management contract,
• Patients with insurance that requires pre-certification for any of the study drugs,
• Inability to make own decisions regarding the informed consent,
• Inability to read and/or understand English,
• Patients who are unable to return for follow-up or be reached by phone.