No Benefit for Intra-Articular Corticosteroids Before Physical Therapy in Patients with Knee Osteoarthritis
Physical therapy (PT), either before or instead of arthroplasty, effectively reduces pain and enhances function in patients with knee osteoarthritis (OA). Although some clinicians give intra-articular corticosteroid injections to reduce pain and inflammation before PT, this approach has never been assessed in a controlled trial. Researchers randomized 100 Danish adults (mean age, 63) with radiographically and clinically confirmed knee OA and without morbid obesity to single intra-articular injections of methylprednisolone acetate (40 mg) plus lidocaine or to saline/lidocaine of equal volume. All patients then participated in thrice-weekly supervised exercise programs for 12 weeks, with about 80% attendance in both groups. At 14 and 26 weeks after injections, both groups had improved substantially in several measures of pain and function, and no significant differences were noted between groups.
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