A Retrospective Database Study Into the Use of Intraarticular Corticosteroid Injections in the Treatment of Knee Osteoarthritis: Does the Profession of the Injecting Clinician Impact Treatment Outcome?

Abstract

Background and purpose: Intra-articular corticosteroid (IAC) injections are widely used as adjuncts to the core non-surgical treatments for knee osteoarthritis. In the UK, they are administered by a range of healthcare professionals working in different settings, including general practitioners in primary care, and physiotherapists in musculoskeletal outpatient settings. The aim of this retrospective database study was to consider the impact of the injecting clinician's profession on treatment outcome.

Method: Data were collected from 1708 patients who received a single IAC injection within a 12-month period, administered by either a physiotherapist (1612 patients) or a doctor (96 patients) within Connect Health Limited's MSK services. Outcome was assessed using the EQ-5D-5L outcome measure. Parametric paired and independent sample t-tests were used, respectively, to examine differences in EQ-5D-5L pre- and post-intervention and based on injecting clinicians.

Results: On average, a statistically significant improvement (p < 0.001) in patients' EQ-5D-5L scores was observed across the study population following an IAC injection. The difference in post-injection EQ-5D-5L scores according to clinicians was also found to be statistically significant (p < 0.001), in favour of physiotherapist-administered IAC injections.

Conclusion: This study confirms the positive impact of IAC injections in the management of knee osteoarthritis, with the results suggesting that injections administered by physiotherapists may produce better outcomes than those administered by doctors.