Physical Therapy Outperforms Steroid Injections for Meniscus Tears with Knee Osteoarthritis: Study
A recent multicenter randomized controlled trial published in BMC Medicine has demonstrated that physical therapy yields significantly better outcomes than glucocorticoid injections for patients with meniscal tears and knee osteoarthritis (KOA) over a one-year period. The study involved 273 patients, randomly assigned to either a physical therapy group (n=133) or a glucocorticoid injection group (n=140). The primary outcome measured was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, which assesses pain, stiffness, and physical function.
After one year, patients in the physical therapy group exhibited a significantly lower average WOMAC score (76.85 ± 2.50) compared to those in the glucocorticoid injection group (99.55 ± 2.09), indicating better overall joint health (mean difference = −22.70; 95% CI: −23.43 to −21.96; p < 0.001). Additionally, the physical therapy group showed superior proprioception, particularly in the eyes-closed in situ stepping test, with a mean score of 14.27 ± 0.75 versus 5.98 ± 0.74 in the injection group (mean difference = 8.29; 95% CI: 8.09–8.50; p < 0.001). The incidence of serious adverse events was comparable between the two groups.
These findings suggest that physical therapy not only improves pain and quality of life but also enhances balance and joint function more effectively than glucocorticoid injections in patients with meniscal tears and KOA. Given the comparable safety profiles and the superior functional outcomes associated with physical therapy, clinicians should consider prioritizing physical therapy as a first-line treatment for this patient population.
Reference:
Lee, M., Jing, C., & Lee, K. (2025). Physical therapy vs. glucocorticoid injection in patients with meniscal tears and knee osteoarthritis: a multi-center, randomized, controlled trial. BMC Medicine, 23, 277. https://doi.org/10.1186/s12916-025-04113-y
