The KINDLE trial: ketorolac vs. triamcinolone injections for lateral epicondylitis- a non-inferiority randomized controlled multicentric trial.

Study Summary

228 adults with lateral epicondylitis were included in this assessor blinded trial in which patients were randomized to receive a single ketorolac injection or triamcinolone injection, with 200 participants completing the 52-week follow-up. The primary outcome was change in Visual Analogue Scale (VAS) pain at rest at 24 weeks. Secondary outcomes included Patient-Rated Tennis Elbow Evaluation (PRTEE), Disabilities of the Arm, Shoulder, and Hand (DASH), grip and pinch strength, wrist and forearm strength, pressure pain threshold, and adverse events. Outcomes were assessed at baseline and 4, 12, 24, and 52 weeks. Overall, ketorolac was non-inferior to triamcinolone for pain reduction at any time point, while functional and strength outcomes were comparable between treatments. However, triamcinolone showed a relative advantage among patients with symptoms lasting ≥12 months, whereas ketorolac caused greater transient post-injection pain. These findings support ketorolac as a steroid-sparing injection option for lateral epicondylitis, particularly when corticosteroids are undesirable.