Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(8):8 N Engl J Med.2020;382(15):1420-1429.What this means for my practice?
Based on this study, physical therapy was significantly better than intra-articular injections. However, these differences may be clinically relevant. Furthermore, the study only enrolled 156 patients. Finally, many patients can and do often undergo physiotherapy and intra-articular injections in a simultaneous manner, and thus it is rarely the case that the treating provider is forced to choose between one of these two treatment options. Further studies are required to reconfirm the findings.
Study Summary
In this multi-centre randomized controlled trial, active duty and retired military service members with knee osteoarthritis were randomized to receive physiotherapy or intra-articular injections. Pain, function, and physical performance were measured at one year post-randomization. 156 patients were enrolled, with 78 in each group. Outcome assessors were blinded. At one year, patients in the physical therapy group had significantly lower (better) total WOMAC scores, as well as faster times on the Step Test and the Timed Up and Go test.
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