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Knee News

Oral Versus Injected Tenoxicam for Acute Osteoarthritic Knees

The main treatment for acute flare-ups of osteoarthritis (OA) of the knee is rest, ice or cold compresses, and nonsteroidal antiinflammatory drugs (NSAIDs). NSAIDs work well because they provide pain relief and reduce swelling and inflammation.

But NSAIDs cause unpleasant side effects in some patients. Gastrointestinal bleeding is one of those complications that can be very serious. Researchers are looking for different ways to administer NSAIDs for the most effective treatment.

In this study, tenoxicam (an NSAID) was either taken orally or given as an injection directly into the knee joint. All patients included had an acute flare-up of synovitis in the knee. Synovitis is an inflammation of the membrane that lines the knee joint. Knee pain and joint swelling occur.

First, the surgeon inserted a long, thin needle into the knee joint and aspirated (removed) the fluid in the knee. For the group who received an intraarticular injection, the same needle was used to deliver the drug.

Pain, joint motion, and number of repeat flare-ups were used as the measures of treatment success. They found that the injection group got faster pain relief and had fewer flare ups compared to the group who received the oral type of tenoxicam.

The authors report that tenoxicam may be the safest NSAID to use for intra-articular injection. The high concentration of NSAID in the joint works better and faster than taking the oral (systemic) doses. With fewer flare-ups, patients in the injection group also had greater function and mobility at the end of a year.

Volkan Oztuna, MD, et al. Intra-articular Injection of Tenoxicam in Osteoarthritic Knee Joints with Effusion. InOrthopedics. December 2007. Vol. 30. No. 12. Pp. 1039-1042.


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