Post injection rest in osteoarthritis of the knee: effect on pain relief and knee function after intra-articular corticosteroids, a prospective randomized controlled trial

Abstract

Primacy osteoarthritis (OA) of the knee is a common clinical problem. One non-operative modality commonly used for symptomatic pain relief is an intra-articular corticosteroid injection. In rheumatoid arthritis patients, a period of rest post-corticosteroid injection (i.e. decreased weight bearing on the extremity), has been shown to improve clinical response. This question has yet to be addressed for patients with primary OA of the knee. -- A twelve week randomized controlled trial was conducted in knee OA patients requiring an intra-articular corticosteroid injection into the knee. Forty-three patients were randomized to the rest group and forty-three to the no rest group. Patients in the rest group were instructed to keep weight bearing activities to a minimum for twenty-four hours after the injection. The no rest group had no physical restrictions placed on them. The primary outcome measure was the total WOMAC Index, which incorporates components of pain, stiffness and function. The WOMAC was measured at two, six, and twelve weeks post-injection. Repeated measures ANCOV A was used to analyze the primary outcome. -- This trial failed to demonstrate any short term clinical benefit of post-injection rest after an intra-articular corticosteroid injection in patients with primary osteoarthritis of the knee.