Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2014
Penetration of topical diclofenac sodium 4 % spray gel into the synovial tissue and synovial fluid of the knee: a randomised clinical trial.
Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Renal Safety of Topical Diclofenac in Adults with Increased Renal Risk: A Systematic Review.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Formulation of Topical Dosage Forms Containing Synthetic and Natural Anti-Inflammatory Agents for the Treatment of Rheumatoid Arthritis.Molecules (Basel, Switzerland) · 2020Trial
- Plasma pharmacokinetics and synovial concentrations of S-flurbiprofen plaster in humans.European journal of clinical pharmacology · 2016Trial
- Treatment Options for Focal Cartilage Lesions of the Knee.Deutsches Arzteblatt international · 2026Review
- Topical Pain Management: An Updated Review of Current Evidence and Emerging Strategies.Journal of clinical medicine · 2026Review
- Topical Percutaneous Drug Delivery for Allergic Diseases: A Novel Strategy for Site-Directed Pharmacologic Modulation.Pharmaceutics · 2025Review
- Relationship between Pharmacokinetic Profile and Clinical Efficacy Data of Three Different Forms of Locally Applied Flurbiprofen in the Mouth/Throat.Pharmaceutics · 2023Article
- Diclofenac and other non-steroidal anti-inflammatory drugs (NSAIDs) are competitive antagonists of the human P2X3 receptor.Frontiers in pharmacology · 2023Article
- Efficacy and Safety of NSAIDs in Infants: A Comprehensive Review of the Literature of the Past 20 Years.Paediatric drugs · 2022Review
- [Conservative treatment options for arthritis of the ankle : What is possible, what is effective?]Der Unfallchirurg · 2022Review
- Topical Diclofenac, an Efficacious Treatment for Osteoarthritis: A Narrative Review.Rheumatology and therapy · 2020Review
- Penetration of topical diclofenac into synovial tissue and fluid of osteoarthritic knees: a multicenter, randomized, placebo-controlled, pharmacokinetic study.Therapeutic advances in musculoskeletal disease · 2020Article
- Bioactive factors for cartilage repair and regeneration: Improving delivery, retention, and activity.Acta biomaterialia · 2019Review
- Topical delivery of 3,5,4'-trimethoxy-trans-stilbene-loaded microemulsion-based hydrogel for the treatment of osteoarthritis in a rabbit model.Drug delivery and translational research · 2019Article
- Pharmacological effects of N-[2-[[2-[2-[(2,6-dichlorophenyl)amino]phenyl]acetyl]oxy]ethyl]hyaluronamide (diclofenac Etalhyaluronate, SI-613), a novel sodium hyaluronate derivative chemically linked with diclofenac.BMC musculoskeletal disorders · 2018Article
- Penetration and efficacy of transdermal NSAIDs in a model of acute joint inflammation.Journal of pain research · 2018Article
- Diclofenac in the treatment of pain in patients with rheumatic diseases.Reumatologia · 2018Review
- Rationale of combination therapy with antioxidants in medical management of Peyronie's disease: results of clinical application.Research and reports in urology · 2017Article
- High prevalence of medication use in professional football tournaments including the World Cups between 2002 and 2014: a narrative review with a focus on NSAIDs.British journal of sports medicine · 2015Review
- Ion channels and osteoarthritic pain: potential for novel analgesics.Current pain and headache reports · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe present study was designed to evaluate the penetration of diclofenac sodium 4 % spray gel in synovial tissue, synovial fluid and blood plasma after topical application in subjects with joint effusions and planned total knee arthroplasty (TKA) due to osteoarthritis.
methodsA total of 39 patients were randomised to two- or three-times daily application of diclofenac sodium 4 % spray gel to knees requiring surgery over a treatment period of 3 days. Within 8 h after the last application, TKA was conducted, and the diclofenac concentrations in synovial tissue, synovial fluid and blood plasma were measured by liquid chromatography.
resultsThe median diclofenac concentration was approximately 10-20-fold higher in synovial tissue (36.2 and 42.8 ng/g) than in synovial fluid (2.6 and 2.8 ng/mL) or plasma (3.9 and 4.1 ng/mL) in both treatment groups. Dose proportionality for any compartment or treatment groups could not be detected. Treatment-related adverse events were noted in two cases and limited to skin reactions.
conclusionDiclofenac sodium 4 % spray gel was found to penetrate the skin locally in substantial amounts and thus reach the desired target tissue. Concentrations were not dose-dependent, and application was well tolerated by 97.4 % of patients. Topical application of diclofenac should be considered a valuable alternative to systemic NSAID therapy in the initial treatment of osteoarthritis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.