• Sang Chul Lee, Dong-Wook Rha, and Won Hyuk Chang.
• Department of Physical Medicine and Rehabilitation, Myongji Hospital, Kwandong University College of Medicine, Koyang, Kyunggi, Korea.
• J Back Musculoskelet Rehabil. 2011 Jan 1; 24 (1): 31-8.

ObjectiveThe purpose of this study was to evaluate the efficacy of intra-articular ketorolac to improve intra-articular hyaluronic acid (HA) therapy in knee osteoarthritis with respect to the initiation of pain relief.MethodsThis study was designed as a single-blind study with a blinded observer and a 3-month follow-up. Forty-three patients with knee osteoarthritis were randomized to the ketorolac group (n=21) or the HA group (n=22). Ketorolac group members were given three weekly intra-articular injections of HA with ketorolac and then two weekly intra-articular injections of HA; and HA group members were given five weekly intra-articular HA injections. Visual analog scale (VAS), pain rating score (PRS) and adverse events were assessed at baseline and at 1st, 3rd, 5th, and 16th week after treatment commencement.ResultsSignificant improvement regarding pain assessment tools was observed in the ketorolac group by the addition of ketorolac to HA as compared with the HA group within 16 weeks of follow-up (p < 0.05). In the ketorolac group, 5 of the 21 subjects developed focal post-injection knee pain for about 8 hours after injection.ConclusionIntra-articular HA with ketorolac showed more rapid analgesic onset than intra-articular HA alone and did not induce any serious complications.

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