Donati Danilo, Giorgi Federica, Domiziano Tarantino, Tarallo Luigi, Catani Fabio, Platano Daniela, Tedeschi Roberto
Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy.
Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena, Italy.
J Pers Med. 2024 Oct 26;14(11):1077. doi: 10.3390/jpm14111077.
Knee osteoarthritis (OA) is a prevalent and disabling condition often managed with physiotherapy or intra-articular injections. However, the comparative effectiveness of these treatments remains unclear. This systematic review aimed to evaluate and compare the efficacy of physiotherapy and intra-articular injections in managing knee OA.
A systematic search of PubMed, Scopus, Web of Science, PEDro, and Cochrane Library was conducted. Randomized controlled trials (RCTs) comparing physiotherapy and intra-articular injections in knee OA patients were included. Key outcomes included pain (VAS), function (WOMAC, KOOS), range of motion (ROM), and quality of life. Data from five studies with a total of 552 participants were analyzed.
Intra-articular injections, particularly botulinum toxin and hyaluronic acid, were found to provide rapid pain relief, outperforming physiotherapy in short-term pain management. However, physiotherapy contributed significantly to long-term functional improvements, particularly in early-stage OA. Combination therapy of injections and physiotherapy yielded the best short-term pain relief and functional outcomes. Heterogeneity in study designs and follow-up periods limited the generalizability of findings.
Intra-articular injections are effective for immediate pain control, while physiotherapy plays a crucial role in maintaining joint function, especially for long-term management. Combining both interventions may offer the most comprehensive benefits. Further research is needed to determine the long-term efficacy of these treatments.
膝关节骨关节炎（OA）是一种常见且致残的疾病，通常采用物理治疗或关节内注射进行治疗。然而，这些治疗方法的相对有效性仍不明确。本系统评价旨在评估和比较物理治疗与关节内注射在治疗膝关节OA中的疗效。
对PubMed、Scopus、Web of Science、PEDro和Cochrane图书馆进行了系统检索。纳入了比较膝关节OA患者物理治疗和关节内注射的随机对照试验（RCT）。主要结局包括疼痛（视觉模拟评分法[VAS]）、功能（Western Ontario和McMaster大学骨关节炎指数[WOMAC]、膝关节损伤和骨关节炎疗效评分[KOOS]）、活动范围（ROM）和生活质量。对五项研究共552名参与者的数据进行了分析。
发现关节内注射，特别是肉毒杆菌毒素和透明质酸，能迅速缓解疼痛，在短期疼痛管理方面优于物理治疗。然而，物理治疗对长期功能改善有显著贡献，尤其是在早期OA患者中。注射与物理治疗的联合治疗产生了最佳的短期疼痛缓解和功能结局。研究设计和随访期的异质性限制了研究结果的普遍性。
关节内注射对立即控制疼痛有效，而物理治疗在维持关节功能方面起着关键作用，特别是在长期管理中。两种干预措施相结合可能会带来最全面的益处。需要进一步研究以确定这些治疗方法的长期疗效。
