Postprocedure protocols after intraarticular orthobiologic injections-A scoping review.
Ryan C Kruse, Kristina D Rossmiller, Timothy R Fleagle
PMID 39382011WHAT IT FOUND
Most orthobiologic studies restrict NSAIDs for months post-injection, but rarely describe physical therapy or weight-bearing limits.
This makes it impossible to know which part of the protocol mattered. Clinicians cannot yet translate these trial rules into specific post-injection advice for patients.
Key findings
01Only 62.5% of included studies described any postprocedure protocol, and among those, NSAID restriction was the most common element.
02Formal physical therapy was included in only 13 protocols, while 35 provided home exercise programs, with highly heterogeneous specifics.
03Weight-bearing restrictions and durable medical equipment were infrequently described, with only two protocols specifying DME use.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review did not analyze the relationship between specific protocols and clinical outcomes. Heterogeneity in reporting means many details of protocols were missing or vague. The protocols described in studies may not reflect real-world clinical practice, particularly regarding long medication restrictions.
Declared interests
One author is a consultant for a company related to the treatment, though stated as not relevant to this article.
The easy way to misread this
Do not assume that the long NSAID restriction periods or specific rehabilitation timelines found in these studies are evidence-based clinical guidelines. The review highlights that these protocols are highly variable and often poorly described, meaning they cannot be reliably applied to patient care or used to judge the effectiveness of the injection itself.