Intra-articular Tenoxicam Versus Triamcinolone Acetonide in Knee Osteoarthritis Management

Comparison of Intra-articular Tenoxicam and Triamcinolone Acetonide in the Management of Knee Osteoarthritis: A Randomized Prospective Study

Knee osteoarthritis is a very common joint condition that leads to pain, stiffness, and difficulty with daily activities, particularly in middle-aged and older adults. Many patients do not get adequate relief from oral pain medications, non-steroidal anti-inflammatory drugs, or physical therapy. Because of this, injections directly into the knee joint are often used.

Corticosteroid medicines, such as triamcinolone acetonide, are among the most frequently used intra-articular injections. They provide strong and rapid anti-inflammatory effects, but their benefits often wear off after only a few weeks. In addition, corticosteroids may cause unwanted systemic effects such as temporary increases in blood sugar, which can be especially concerning for patients with diabetes.

Non-steroidal anti-inflammatory drugs are another group of medicines that can relieve pain and inflammation. Tenoxicam is a long-acting medicine from this group. When given directly into the knee joint, tenoxicam may provide local pain relief for a longer duration, while reducing the amount of drug that circulates in the body. This may lower the risk of side effects compared with oral treatment or repeated corticosteroid injections.

This clinical study was designed to compare the effects of a single intra-articular injection of tenoxicam with a single intra-articular injection of triamcinolone acetonide in patients who have symptomatic knee osteoarthritis. The primary aim was to determine which treatment provides better improvement in knee pain, measured using a visual analog scale. Secondary aims included evaluating knee function using the Western Ontario and McMaster Universities Osteoarthritis Index, monitoring blood sugar control using glycated hemoglobin testing, and assessing the safety of each treatment by recording any local or general adverse events.

Inclusion Criteria:

• Adults aged 45 to 75 years
• Radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade II-III)
• Persistent knee pain for at least 3 months despite oral non-steroidal anti-inflammatory drugs
• Ability to provide informed consent

Exclusion Criteria:

• Prior intra-articular injection within the past 6 months
• Inflammatory arthritis (e.g., rheumatoid arthritis, gout)
• Advanced knee osteoarthritis (Kellgren-Lawrence grade IV)
• Active joint or systemic infection
• Bleeding disorder or anticoagulant use contraindicating injection
• Uncontrolled diabetes mellitus
• Known hypersensitivity to tenoxicam or triamcinolone acetonide