Comparison of Efficacy Between Intra-Articular Tramadol versus Intraticular Corticosteriod Injection in Knee Osteoathritis
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-10.11105Keywords:
Knee, Osteoarthritis, Intra-articular Corticosteroid Injection, Tramadol InjectionAbstract
Objective: To compare the efficacy between intra-articular Tramadol versus intra-articular corticosteroid injection in knee osteoarthritis.
Study Design: Quasi Experimental Study.
Place and Duration of Study: Department of Orthopedic Surgery, Combined Military Hospital, Abbottabad Pakistan from Mar to Sept 2022.
Methodology: The study included 92 individuals who were diagnosed with knee osteoarthritis by a consultant orthopaedic surgeon and who presented with joint discomfort (WOMAC Score > 35mm). Two groups of forty-six patients each were formed through lottery method. The first group of patients received injections of intra-articular corticosteroids, whereas the second group received injections of intra-articular Tramadol. At the 4, 8, and 12 week follow-up appointments, patients were evaluated again. Pain, stiffness, and physical function were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) version 3.1. The pain scale ranged from 0 (no pain) to 100 (worst possible pain), and the effectiveness was determined by the amount of alleviation observed. A 70% decrease in symptoms from baseline was considered an efficacy label.
Results: In terms of alleviating symptoms of Knee Osteoarthritis, intra-articular corticosteroid injection was found to be considerably better than intra-articular Tramadol injection, in 40 cases (87.0%) compared to 22 cases (47.8%), with a p-value of less than 0.001.
Conclusion: Injections of intra-articular corticosteroids were far more effective than injections of intra-articular Tramadol in alleviating symptoms and improving WOMAC scores in patients suffering from knee osteoarthritis, according to this research.
Downloads
References
1. Springer BD. Management of the Bariatric Patient. What Are the Implications of Obesity and Total Joint Arthroplasty: The Orthopedic Surgeon's Perspective? J Arthroplast 2019; 34(7S): S30-S32. https://doi.org/10.1016/j.arth.2018.12.021
2. Elsiwy Y, Jovanovic I, Doma K, Hazratwala K, Letson H. Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review. J Orthop Surg Res 2019; 14(1): 15.
3. Lundgren-Nilsson Å, Dencker A, Palstam A, Person G, Horton MC, Escorpizo R, et al. Patient-reported outcome measures in osteoarthritis: a systematic search and review of their use and psychometric properties. RMD Open 2018; 4(2): e000715. https://doi.org/10.1136/rmdopen-2018-000715
4. Manlapaz DG, Sole G, Jayakaran P, Chapple CM. Risk Factors for Falls in Adults with Knee Osteoarthritis: A Systematic Review. Phys Med Rehab J 2019; 11(7): 745-757.
https://doi.org/10.1002/pmrj.12066
5. Hulshof CTJ, Colosio C, Daams JG, Ivanov ID, Prakash KC, Kuijer PPFM, et al. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational ergonomic risk factors and of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases. Environ Int 2019;125: 554-566.
6. Buyuk AF, Kilinc E, Camurcu IY, Camur S, Ucpunar H, Kara A. Compared efficacy of intra-articular injection of methylprednisolone and triamcinolone. Acta Ortop Bras 2017; 25(5): 206-208.
7. Xu J, Qu Y, Li H, Zhu A, Jiang T, Chong Z, et al. Effect of Intra-articular Ketorolac Versus Corticosteroid Injection for Knee Osteoarthritis: A Retrospective Comparative Study. Orthop J Sports Med 2020; 8(4): 2325967120911126.
8. Shahid HP, Muhammad M, Rizwan J, Imran SK, Rizwan H. Comparison of Intra-Articular Steroids Injection Versus Platelets Rich Plasma Injection in Patients with Osteoarthritic Knee Joints. Pak J Med Health Sci. 2018; 12(3): 931-934.
9. Zhang X, Li X, Xiong Y, Wang Y, Wei J, Zeng C, et al. Efficacy and Safety of Tramadol for Knee or Hip Osteoarthritis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Arthritis Care Res 2023; 75(1): 158-165.
http://doi.org/10.1002/acr.24750
10. Rashid M, Iqbal W, Butt AW, Jamshed O. comparison between intra-articular steroid injection and ultrasound therapy in management of chronic knee osteoarthritis. Pakistan Armed Forces Med J. 2022; 72(1): 181–184.
11. Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022 WSAVA guidelines for the recognition, assessment, and treatment of pain. J Small Anim Pract 2023; 64: 177-254. https://doi.org/10.1111/jsap.13566
12. Mukhopadhyay K, Ghosh P, Ghorai P, Hazra A, Das AK. Oxaceprol versus Tramadol for knee osteoarthritis: A randomized controlled trial. Indian J Pharmacol 2018; 50(5): 266-272.
13. Jones DF, Hodgden JD, Onarecker CD. In adults with osteoarthritis of the knee, is conservative management more effective than intra-articular corticosteroid injections in relieving pain? J Okla State Med Assoc 2018; 111(7): 712-713.
14. Testa G, Giardina SMC, Culmone A, Vescio A, Turchetta M, Cannavò S, Pavone V. Intra-Articular Injections in Knee Osteoarthritis: A Review of Literature. J Funct Morphol Kinesiol 2021; 6(1): 15.
15. Primorac D, Molnar V, Matišić V, Hudetz D, Jeleč Ž, Rod E, et al. Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies’ Guidelines. Pharmaceuticals 2021; 14(3): 205.
16. Najm A, Alunno A, Gwinnutt JM, Weill C, Berenbaum F. Efficacy of intra-articular corticosteroid injections in knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Joint Bone Spine 2021; 88(4): 105198. http://doi.org/10.1016/j.jbspin.2021.105198
17. Kim KH, Suh JW, Oh KY. The effect of intra-articular hyaluronate and Tramadol injection on patients with adhesive capsulitis of the shoulder. J Back Musculoskelet Rehabil 2017; 30(4): 913-920. http://doi.org/10.3233/BMR-160641
18. Kawai S, Sobajima S, Jinnouchi M, Nakano H, Ohtani H, Sakata M, et al. Efficacy and Safety of Tramadol Hydrochloride Twice-Daily Sustained-Release Bilayer Tablets with an Immediate-Release Component for Chronic Pain Associated with Knee Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled, Treatment-Withdrawal Study. Clin Drug Investig 2022; 42(5): 403-416. http://doi.org/10.1007/s40261-022-01139-5
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Muhammad Adnan Afsar, Ziauddin Khan, Adnan Anwar, Shoaib Zardad, Muhammad Awais Jameel, Tahir Nawaz
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
