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The Effectiveness of Betamethasone Compared to Triamcino
lone Acetonide as Single Intra-Articular Injection in Knee
Osteoarthritis: A Double-Blinded, Randomized Controlled Trial
Kittipong Wattanasirisombat, Krit Boontanapibul, Punnawit Pinitchanon, Piya Pinsornsak*
Department of Orthopedic, Faculty of Medicine, Thammasat University
*Corresponding Author E-mail: pinpiya2003@yahoo.com
Background: Abstract
Intra-articular (IA) corticosteroid injections are commonly used for pain relief and improved
function in knee osteoarthritis (OA). However, the optimal steroid preparation remains
controversy. This study aimed to compare the efficacy of single-shot long-acting steroid
(betamethasone) and intermediate-acting steroid (triamcinolone acetonide) injections in
knee OA.
Methods: This single-center, double-blind, randomized controlled trial included 120 patients with
symptomatic knee OA, who were randomized to receive either betamethasone (5 + 2 mg)
or triamcinolone acetonide (40-mg) IA injection and followed for 6 months. The primary
outcome was the Visual Analog Scale (VAS) pain (0-100) at rest at 6 months. Secondary
outcomes were VAS pain during movement, knee flexion angle, modified WOMAC score,
UCLA activity score, Time Up-and-Go test (TUG), 2-minute walk test (2MWT), and side
effects. The analysis focused on between-group comparisons using multilevel regression
models.
Results: Conclusion: Both betamethasone and triamcinolone groups demonstrated significant reductions in VAS
pain at rest from day 1 through 6 months. At 6 months, the between-group mean difference
in VAS pain at rest was -1 (95% CI, -11 to 8; P = 0.77), indicating no statistically significant
difference. Similarly, at 6 months, no significant between-group differences were observed
for VAS pain during movement (-3 [-13 to 7], P = 0.51), flexion angle (6 [1 to 10], P = 0.20),
WOMAC score (-4 [-11 to 4], P = 0.91), UCLA score (0 [-0.5 to 0.6], P = 0.46), Timed Up and
Go test (-1 [-3 to 1], P = 0.88), or 2-Minute Walk Test (9 [-1 to 19], P = 0.47). Acetaminophen
and tramadol use was numerically lower in the betamethasone group, but not statistically
significant (P > 0.05). No serious adverse events occurred.
Betamethasone and triamcinolone acetonide both effectively reduced pain, and improved
function and performance scores for up to 6 months, with no significant differences
between the two treatments.
Harmony in health: Innovation for Sustainable Medicine
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