Joint Corticosteroid Injection Associated With Higher Physical Therapy Compliance in Knee Osteoarthritis

Area of Science:

• Orthopedics
• Rheumatology
• Physical Medicine and Rehabilitation

Background:

• Knee osteoarthritis (KOA) is a prevalent condition managed with physical therapy (PT) and corticosteroid injections (KCSI).
• Adherence to PT can be a challenge, particularly in underserved communities, potentially limiting treatment efficacy.
• KCSI may serve as a precursor to enhance PT engagement for KOA patients.

Purpose of the Study:

• To investigate the impact of KCSI on PT adherence and utilization among patients with KOA.
• To determine if KCSI influences the likelihood of attending PT sessions and the total number of visits in a resource-limited setting.

Main Methods:

• Retrospective cohort analysis of 132 patients with KOA referred for PT between January 2018 and December 2019.
• Patients were stratified into two groups: those receiving KCSI around the time of PT referral and those who did not.
• PT adherence was assessed by comparing the proportion of patients attending at least one visit and the total number of PT visits between the groups.

Main Results:

• Patients receiving KCSI were significantly more likely to attend at least one PT visit (47.4% vs. 22.3%) compared to those without KCSI.
• The odds ratio for undergoing PT was 1.38 (p=0.002), and the rate ratio for PT visits was 2.50 (p=1.36 × 10^-8), adjusted for covariates.
• Among patients who attended PT, the mean number of visits was similar across both groups (5.4 visits).

Conclusions:

• KCSI prior to PT is associated with increased likelihood of PT initiation and higher overall PT visit rates in KOA patients.
• This finding is particularly relevant for predominantly Hispanic populations and resource-limited settings where PT adherence may be suboptimal.
• KCSI may be a valuable strategy to improve the effectiveness of PT for knee osteoarthritis management.