A Comparison of Manual Physical Therapy and Corticosteroid Injections for Knee Osteoarthritis



Status:Active, not recruiting
Conditions:Arthritis, Osteoarthritis (OA)
Therapuetic Areas:Rheumatology
Healthy:No
Age Range:38 - Any
Updated:8/2/2017
Start Date:August 2012
End Date:December 2018

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Orthopaedic Manual Physical Therapy Versus Corticosteroid Injections for Osteoarthritis of the Knee

The purpose of this study is to compare an orthopaedic manual physical therapy (OMPT) to
corticosteroid injection for the management of knee osteoarthritis.

The purpose of this study is to compare a commonly offered clinical approach of a series of
intra-articular steroid injections to an orthopaedic manual physical therapy (OMPT) approach
consisting of manually applied passive movement and reinforcing exercise for the treatment of
osteoarthritis of the knee (knee OA). A second purpose is to validate a clinical prediction
rule (CPR) for patients unlikely to respond to the orthopaedic manual physical therapy
approach in a pre-planned secondary analysis of data from the randomized clinical trial.

Aim 1: To see if there is a significant difference in pain and function lasting out to 1 year
for patients that receive a clinical approach consisting of a series of intra-articular
steroid injections compared to those that receive a clinical approach consisting of
orthopaedic manual physical therapy.

Aim 2: To validate a clinical prediction rule of characteristics identified in a previous
preliminary study that predicted which patients with knee OA would be unlikely to respond to
OMPT.

Inclusion Criteria:

- All subjects must be eligible for care in the military health system

- Meet Altman's clinical criteria for knee OA

- Have English language skills sufficient to complete the WOMAC and GROC outcome
instruments

- Be 38 years of age or older

Exclusion Criteria:

- Steroid injections or physical therapy treatment for their knee in the past 12 months

- Current or past history of rheumatoid arthritis or similar rheumatic condition

- Current or past history of gout or pseudogout of the knee

- Active infection in the knee within the past 12 months

- Other physical ailment or condition that is typically more limiting or painful than
their knee OA during activities such as sitting, standing, walking, or stair climbing

- History of allergy or adverse effect to corticosteroids

- Cannot speak/read English adequately to understand and provide consent to participate
in the study

- Pregnant or intending to become pregnant

- Military service members pending a medical evaluation board, physical evaluation
board, equivalent discharge process, or on medical hold to determine long-term
disposition. For non-military personnel, anyone that is pending or undergoing any
litigation for this condition.

- Contraindication to receiving a corticosteroid injection (history of allergic or
adverse reaction to steroid injection, history of multiple corticosteroid injections
in that area even if not within last year, etc)

- Unable to give informed consent to participate in the study.
We found this trial at
2
sites
9040 Jackson Ave
Tacoma, Washington 98431
(253) 968-1110
Madigan Army Medical Center Located on Joint Base Lewis-McChord, Madigan Army Medical Center comprises a...
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Tacoma, WA
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San Antonio, Texas 78234
Phone: 210-808-2582
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San Antonio, TX
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