THE USE OF HYDROCORTISONE ACETATE (COMPOUND F ACETATE) IN THE TREATMENT OF SOME COMMON ORTHOPAEDIC CONDITIONS

¹ Section of Orthopaedic Surgery, Mayo Clinic
² Division of Medicine, Mayo Clinic

A study has been made of the results after local injections of hydrocortisone acetate (compound F acetate) in the treatment of some common orthopaedic conditions. In the treatment of rheumatoid arthritis, marked improvement was noted in the condition of 49 per cent. of the injected joints, whereas improvemenst was moderate in 35 per cent. and mild in 13 per cent.; no relief was obtained in 3 per cent. of the joints into which this material was injected. The relief of symptoms persisted for two to eight days in most cases. When improvement was more prolonged, some additional factor usually was present; among the more important of these was general improvement in the status of the rheumatoid arthritis, either sponstaneous or induced by other forms of treatment. Brief systemic effects were noted in 21 per cent. of the patients who had rheumatoid arthritis and who received injections of hydrocortisone acetate. Intra-articular injection of hydrocortisone acetate appears to be a helpful adjunct in the treatment of rheumatoid arthritis, especially in patients who have involvement of only a few joints or in whom other measures of treatment are generally adequate except in a few joints.

Marked improvement occurred in 38 per cent. of the injected joints in patients who had osteo-arthritis; moderate improvement was noted in 34 per cent., mild in 7 per cent., and insignificant in 21 per cent. The improvement usually lasted for one to eight days; when more prolonged improvement was noticed, other factors, such as increased rest ansd limitations of weight-bearing activities, appeared to play a role. This form of treatment apparently is helpful as an adjunct in the management of osteo-arthritic patients, particularly those suffering from acute or subacute flare-ups or those in whom maximal applications of other conservative measures has failed to relieve discomfort.

Limited experience with intra-articular injections of hydrocortisone acetate in the treatment of traumatic synovitis, psoriatic arthritis, and acute gouty arthritis suggests that its temporary antirheumatic effect might be helpful in the management of these conditions. Use of hydrocortisone acetate in the treatment of epicondylitis (tennis elbow) has proved discouraging to date.

The most favorable response to local treatment by injection of hydrocortisone acetate apparently occurs in self-limited conditions, such as traumatic bursitis. Injection of hydrocortisone acetate appears to hasten the recovery and shorten the period of convalescence.

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