ClinicalTrials.gg
TerminatedNCT03694821Updated Feb 18, 2020Results posted

Knee Injection RCT

A Phase 4 interventional study of Ketorolac Tromethamine Injection and Methylprednisolone Acetate Injection in Osteoarthritis, sponsored by UConn Health. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-02-18.

Sponsored by UConn Health · Phase 4, Interventional, and Treatment

Why this study was terminated
Low enrollment
Phase
Phase 4
Study type
Interventional
Enrollment
18
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Hypothesis: Ketorolac injection is a cost-effective adjunct in the nonoperative treatment of knee osteoarthritis (OA) compared to steroids and viscosupplementation.

Aims/objectives: The objective of this randomized, controlled, double-blinded, prospective study is to assess the efficacy and cost-effectiveness of knee injection with ketorolac in the nonsurgical management of symptomatic OA compared to injections with corticosteroids and viscosupplements.

Read the detailed description

The purpose of this research study is to examine the effectiveness of intra-articular (inside the joint) ketorolac injection compared to injection with either corticosteroid or hyaluronic acid for the treatment of painful knee osteoarthritis. Patients will be randomly assigned to receive either ketorolac (a nonsteroidal anti-inflammatory drug, methylprednisolone (a steroid), hyaluronic acid (a substance that is naturally present in the human body).

02

Conditions studied

  • Osteoarthritis

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Keywords

  • Osteoarthritis
  • Knee
  • Injection
  • Ketorolac
03

In context

Osteoarthritis

4,445 studies on the registry are indexed under Osteoarthritis; 582 are open to participants now.

This study's enrollment of 18 is below the median of 70 across 3,474 interventional studies indexed under Osteoarthritis.

Browse Osteoarthritis studies →

Lead sponsor

UConn Health is the lead sponsor of 187 studies on the registry; 18 are open to participants now.

Of its 10 completed or terminated interventional studies of FDA-regulated products, 7 (70%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients over the age of 18 who present with 1) symptomatic knee OA and radiographic evidence of joint space narrowing and 2) are interested in knee injections for pain relief.

Exclusion criteria

Exclusion Criteria:

  • Prior injections into the same knee within the past 6 months,
  • Pregnant and/or lactating women,
  • Inflammatory joint disease including rheumatoid or psoriatic arthritis,
  • Concurrent use of anti-rheumatic drugs,
  • Allergy or hypersensitivity to the study medications,
  • Patients on an active pain management contract,
  • Patients with insurance that requires pre-certification for any of the study drugs,
  • Inability to make own decisions regarding the informed consent,
  • Inability to read and/or understand English,
  • Patients who are unable to return for follow-up or be reached by phone.
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
18 participants (actual)

Study arms

  • Experimental
    Ketorolac

    One knee injection of 2cc of ketorolac tromethamine (15mg/cc) in 5cc of 0.5% ropivacaine hydrochloride without epinephrine

    Drug: Ketorolac Tromethamine Injection

  • Active comparator
    Corticosteroid

    One knee injection of 2 cc of methylprednisolone acetate (40mg/cc) in 5cc of 0.5% ropivacaine hydrochloride without epinephrine

    Drug: Methylprednisolone Acetate Injection

  • Active comparator
    Hyaluronic Acid

    One knee injection of Hylan G-F 20 (Synvisc-One)

    Drug: Hylan G-F 20

Interventions

  • One knee injection of 2cc of ketorolac tromethamine (15mg/cc) in 5cc of 0.5% ropivacaine hydrochloride without epinephrine

    Also known as: Ketorolac Tromethamine; NDC 63323-162-02; J Code J1885

  • One knee injection of 2 cc of methylprednisolone acetate (40mg/cc) in 5cc of 0.5% ropivacaine hydrochloride without epinephrine

    Also known as: DEPO-MEDROL; NDC 0009-3073-01; J Code J1030

  • One knee injection of Hylan G-F 20 (Synvisc-One)

    Also known as: Synvisc-One; NDC 58468-0090-03; J Code J7325

06

What researchers measure

Primary outcomes

  1. Visual Analogue Pain Scale (VAS)

    average knee pain between 0 (no pain) and 10 (worst pain) 3 months following injection

    Time frame: 3 months post injection

Secondary outcomes

  1. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

    self-reported pain, stiffness and functioning

    Time frame: 3 and 6 months post injection

  2. Oxford Knee Questionnaire

    self-reported pain, stiffness and functioning

    Time frame: 3 and 6 months post injection

  3. Koos, Jr. Knee Survey

    self-reported pain, stiffness and functioning

    Time frame: 3 and 6 months post injection

  4. Visual Analogue Pain Scale (VAS)

    average knee pain between 0 (no pain) and 10 (worst pain) 6 months following injection

    Time frame: 6 months

  5. Patient Satisfaction

    satisfaction with treatment rated as "Yes" or "No"

    Time frame: 3 and 6 months post injection

  6. Non-routine Visits Due to Inadequate Pain Relief or Complications

    Any additional visits due to inadequate pain relief or complications

    Time frame: 3 months post injection

  7. Cost of Intervention

    cost of each injection

    Time frame: 3 months post injection

07

Results

Posted Feb 18, 2020

Participant flow

Participant flow — Overall Study
MilestoneKetorolacCorticosteroidHyaluronic Acid
Started486
Completed002
Not completed484
Withdrew: Study terminated484

Outcome measures

PrimaryVisual Analogue Pain Scale (VAS)

average knee pain between 0 (no pain) and 10 (worst pain) 3 months following injection

Time frame:
3 months post injection

No measurements were reported for this outcome.

SecondaryWestern Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

self-reported pain, stiffness and functioning

Time frame:
3 and 6 months post injection

No measurements were reported for this outcome.

SecondaryOxford Knee Questionnaire

self-reported pain, stiffness and functioning

Time frame:
3 and 6 months post injection

No measurements were reported for this outcome.

SecondaryKoos, Jr. Knee Survey

self-reported pain, stiffness and functioning

Time frame:
3 and 6 months post injection

No measurements were reported for this outcome.

SecondaryVisual Analogue Pain Scale (VAS)

average knee pain between 0 (no pain) and 10 (worst pain) 6 months following injection

Time frame:
6 months

No measurements were reported for this outcome.

SecondaryPatient Satisfaction

satisfaction with treatment rated as "Yes" or "No"

Time frame:
3 and 6 months post injection

No measurements were reported for this outcome.

SecondaryNon-routine Visits Due to Inadequate Pain Relief or Complications

Any additional visits due to inadequate pain relief or complications

Time frame:
3 months post injection

No measurements were reported for this outcome.

SecondaryCost of Intervention

cost of each injection

Time frame:
3 months post injection

No measurements were reported for this outcome.

Adverse events

Collected over 12 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Ketorolac0/4 (0%)0/4 (0%)1/4 (25%)
Corticosteroid0/8 (0%)0/8 (0%)0/8 (0%)
Hyaluronic Acid0/6 (0%)0/6 (0%)0/6 (0%)
Most frequent other events
Most frequent other events
EventKetorolacCorticosteroidHyaluronic Acid
Stomach acheGastrointestinal disorders1/40/80/6

Baseline characteristics

Only age, sex, race and ethnicity data available. No other analysis completed due to study termination.

Age, Categorical
Age, Categorical(Participants)KetorolacCorticosteroidHyaluronic AcidTotal
<=18 years0000
Between 18 and 65 years46414
>=65 years0224
Sex: Female, Male
Sex: Female, Male(Participants)KetorolacCorticosteroidHyaluronic AcidTotal
Female25411
Male2327
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)KetorolacCorticosteroidHyaluronic AcidTotal
Hispanic or Latino1113
Not Hispanic or Latino37515
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)KetorolacCorticosteroidHyaluronic AcidTotal
American Indian or Alaska Native0000
Asian0000
Native Hawaiian or Other Pacific Islander0000
Black or African American0314
White34411
More than one race0000
Unknown or Not Reported1113
08

Study locations

1 site
  • UConn Health
    Farmington, Connecticut 06032, United States
09

References and documents

Publications

  • Dieppe PA, Lohmander LS. Pathogenesis and management of pain in osteoarthritis. Lancet. 2005 Mar 12-18;365(9463):965-73. doi: 10.1016/S0140-6736(05)71086-2. PubMed 15766999 ↗
  • Hootman JM, Helmick CG. Projections of US prevalence of arthritis and associated activity limitations. Arthritis Rheum. 2006 Jan;54(1):226-9. doi: 10.1002/art.21562. PubMed 16385518 ↗
  • Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States. http://www.boneandjointburden.org/2014-report/ivh12/osteoarthritis-and-allied-disorders
  • Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg. 2013 Sep;21(9):571-6. doi: 10.5435/JAAOS-21-09-571. PubMed 23996988 ↗
  • Gray RG, Gottlieb NL. Intra-articular corticosteroids. An updated assessment. Clin Orthop Relat Res. 1983 Jul-Aug;(177):235-63. PubMed 6345042 ↗
  • Hunter DJ. Viscosupplementation for osteoarthritis of the knee. N Engl J Med. 2015 Mar 12;372(11):1040-7. doi: 10.1056/NEJMct1215534. No abstract available. PubMed 25760356 ↗
  • van der Weegen W, Wullems JA, Bos E, Noten H, van Drumpt RA. No difference between intra-articular injection of hyaluronic acid and placebo for mild to moderate knee osteoarthritis: a randomized, controlled, double-blind trial. J Arthroplasty. 2015 May;30(5):754-7. doi: 10.1016/j.arth.2014.12.012. Epub 2014 Dec 13. PubMed 25548079 ↗
  • Campbell KA, Erickson BJ, Saltzman BM, Mascarenhas R, Bach BR Jr, Cole BJ, Verma NN. Is Local Viscosupplementation Injection Clinically Superior to Other Therapies in the Treatment of Osteoarthritis of the Knee: A Systematic Review of Overlapping Meta-analyses. Arthroscopy. 2015 Oct;31(10):2036-45.e14. doi: 10.1016/j.arthro.2015.03.030. Epub 2015 May 19. PubMed 25998016 ↗
  • Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage. 2013 Jan;21(1):16-21. doi: 10.1016/j.joca.2012.11.012. Epub 2012 Nov 27. PubMed 23194896 ↗
  • Brown GA. AAOS clinical practice guideline: treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg. 2013 Sep;21(9):577-9. doi: 10.5435/JAAOS-21-09-577. No abstract available. PubMed 23996989 ↗
  • Reuben SS, Connelly NR. Postoperative analgesia for outpatient arthroscopic knee sugery with intraarticular bupivacaine and ketorolac. Anesth Analg. 1995 Jun;80(6):1154-7. doi: 10.1097/00000539-199506000-00015. PubMed 7762844 ↗
  • Desai A, Ramankutty S, Board T, Raut V. Does intraarticular steroid infiltration increase the rate of infection in subsequent total knee replacements? Knee. 2009 Aug;16(4):262-4. doi: 10.1016/j.knee.2008.12.002. Epub 2009 Jan 12. PubMed 19138855 ↗
  • Jones AC, Pattrick M, Doherty S, Doherty M. Intra-articular hyaluronic acid compared to intra-articular triamcinolone hexacetonide in inflammatory knee osteoarthritis. Osteoarthritis Cartilage. 1995 Dec;3(4):269-73. doi: 10.1016/s1063-4584(05)80018-4. PubMed 8689462 ↗
  • Leardini G, Mattara L, Franceschini M, Perbellini A. Intra-articular treatment of knee osteoarthritis. A comparative study between hyaluronic acid and 6-methyl prednisolone acetate. Clin Exp Rheumatol. 1991 Jul-Aug;9(4):375-81. PubMed 1934686 ↗
  • Bellamy JL, Goff BJ, Sayeed SA. Economic Impact of Ketorolac vs Corticosteroid Intra-Articular Knee Injections for Osteoarthritis: A Randomized, Double-Blind, Prospective Study. J Arthroplasty. 2016 Sep;31(9 Suppl):293-7. doi: 10.1016/j.arth.2016.05.015. Epub 2016 May 18. PubMed 27402605 ↗

Study documents

  • Protocol and statistical analysis plan · Jun 25, 2019

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 18, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03694821
Lead sponsor
UConn Health
Collaborators
Orthopedic Research and Education Foundation
Responsible party
Sponsor
First posted
Oct 3, 2018
Start date
Jul 5, 2018
Primary completion
Jul 16, 2019
Completion
Jul 16, 2019
Results posted
Feb 18, 2020
Last update
Feb 18, 2020

Study contacts

Mohamad J. Halawi, MD
principal investigator · UConn Health

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Ketorolac Tromethamine

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