Treatment of osteoarthritis of the knees.

Relatively little has been published about the treatment of osteo-arthritis. Therapy consists mainly of analgesic drugs and local measures such as intra-articular corticosteroids and short-wave diathermy. Few controlled trials have been done and it is difficult to evaluate some reports owing to lack of distinction of response in patients with rheumatoid arthritis and those with osteo-arthritis (Hollander, Brown, Jessar, and Brown, 1951; Duff, 1956; Zuckner, Machek, and Ahern, 1956; Bonner, 1959). In a study of the value of intra-articular therapy in rheumatic diseases, we have shown that in rheumatoid arthritis intra-articular injections of hydrocortisone acetate and hydrocortisone tertiary butyl acetate produce improvement in pain, tenderness, walking time, range of movement, and limitation of extension (Chandler, Wright, and Hartfall, 1958). In contrast, a trial of these two drugs in osteoarthritis, conducted under exactly similar conditions, showed only a transient relief of pain (Wright, Chandler, Morison, and Hartfall, 1960). It was noted, moreover, that with 33 per cent. of patients there was improvement from the injection of inert material, and this interesting problem formed the basis of a further study by Morison, Woodmansey, and Young (1961). The present controlled study was designed therefore to ascertain the relative value of courses of placebo tablets, placebo injections, and short-wave diathermy in the treatment of osteo-arthritis.