The effect of intra-articular extended-release triamcinolone acetonide on OARSI-recommended physical performance measures in adults with bilateral symptomatic knee osteoarthritis

OBJECTIVE: While the effect of triamcinolone acetonide extended-release (TA-ER) on reducing knee osteoarthritis (OA) pain has been reported, the effects on physical performance are incompletely understood. This open label clinical trial systematically evaluated the effects of intra-articular TA-ER on physical performance, self-reported function, and quality of life in participants with bilateral symptomatic knee OA 6, 12 (primary) and 24 weeks following bilateral injection of TA-ER (32 ​mg). METHODS: Seventy participants were enrolled (61.4% women; age 64.0 ​± ​11.7; BMI 31.8 ​± ​5.7 ​kg/m(2)). Physical performance was measured by 30-s chair stand test, 40 ​m fast paced walk test (FPWT), and stair negotiation test at baseline and each follow-up visit. Physical function and quality of life (QOL) were measured with the Knee Injury and Osteoarthritis Outcome Score (KOOS-PS) and pain was measured with numeric rating scale (NRS). RESULTS: In comparison with baseline, self-reported pain, function, and quality of life were improved at each follow-up through 24 weeks and the number of chair-stands significantly improved following treatment by (mean ​± ​SE) 1.9 ​± ​0.6 ​at 6-week (p ​= ​0.0048) and by 1.8 ​± ​0.5 ​at 12-week follow-up (p ​= ​0.0011) but was not statistically significant at 24-week follow-up (0.6 ​± ​0.6; p ​= ​0.4711). Stair negotiation times were 7.2 ​± ​3.7, 7.1 ​± ​3.8, and 5.4 ​± ​4.0 ​s lower at the three respective follow-up timepoints, although these changes did not reach statistical significance (p ​= ​0.0530, p ​= ​0.0599, and p ​= ​0.1793 respectively). The 40m-FPWT time did not significantly improve. CONCLUSION: These data indicate improvement in chair stand performance through 12 weeks post-injection and sustained improvement in participant-reported physical function through 24-week follow-up in adults with bilateral painful knee OA treated with TA-ER.