Adapted from Osteoarthritic and Cartilage, April, 2019. Author Dr. Daniel Rhon, DPT, DSc:
Toronto – Eight physical therapy session spread over 4-6 weeks in patients with knee osteoarthritis provided significantly greater and longer-lasting improvements in both pain and function than a cortisone injection in arandomized, multicenter trial with 12 months of follow up.
“Considering the very low utilization rate of physical therapy prior to knee replacement, perhaps we should more often give it a try before declaring that conservative care has failed and moving on to surgical management,” concluded Dr. Rhon, director of the primary care musculoskeletal research center at Brooke Army Medical Center in San Antonio.
Various studies have shown that close to 50% of patient with knee OA receive one or more cortisone injections within 5 years prior to having a total knee replacement, compared with physical therapy in only about 10% of patients, even though guidelines rate both as first-line therapies.
“Physical therapy provided a clinically important benefit that was superior to cortisone injection out to 1 year, while also providing the short-term benefit typically sought from cortisone injection,” Dr. Rhon observed.
Another point brought up is that the physical therapy approach offers an important side benefit: In addition to improving pain and function, the exercise regimen has a favorable effect on comorbid metabolic diseases (diabetes, high cholesterol, obesity, etc.) commonly associated with knee arthritis.