Intra-Articular Tramadol Versus Triamcinolone for Knee Osteoarthritis in Primary Care: A Randomized Controlled Trial Addressing Access to Joint Pain Management
A.R. Zorzi, W.T. De Morais, A.L.C. De Medeiros, W.E. De Brito, G.C. De CamposObjective:
To compare the analgesic efficacy and safety of intra-articular tramadol versus triamcinolone in the management of chronic pain in patients with mild to moderate knee osteoarthritis.
Methods:
This prospective, randomized, double-blind clinical trial included 44 patients with mild to moderate knee osteoarthritis and refractory chronic pain treated in primary care settings. Participants received a single intra-articular injection of tramadol (1 mL; 50 mg) or triamcinolone (2 mL; 40 mg). Pain was assessed using the Visual Analog Scale (VAS) for movement-related, nocturnal, and rest pain at baseline and at 15, 30, and 90 days. Both within-group and between-group analyses were performed, and adverse events were recorded.
Results:
Between-group analyses did not demonstrate statistically significant differences between intra-articular tramadol and triamcinolone for nocturnal pain or movement-related pain at any follow-up time point (p > 0.05). A statistically significant difference was observed only for rest pain at 30 days, favoring triamcinolone (p = 0.05).
Conclusion:
Intra-articular tramadol was safe, accessible, and potentially effective, representing a promising therapeutic alternative for patients with contraindications to corticosteroid use. Future studies with larger sample sizes and higher doses are warranted to better define its role in the management of chronic knee osteoarthritis pain.