Weight bearing following intra-articular steroid injection of the knee: survey of current practice and review of the available evidence

Introduction Intra-articular steroid therapy is one of the most common clinical procedures performed by rheumatologists. There is wide variation in the postoperative instructions given to patients following such injections. Aim The aim of this study was to determine what advice is given with regards to non-weight-bearing following steroid injections of the knee by rheumatologists, orthopaedic surgeons, and general practitioners (GPs). Method A questionnaire examining advice on non-weight-bearing following knee steroid injections was posted to 100 rheumatologists, 100 orthopaedic surgeons, and 50 GPs. Results A significant proportion of respondents advised patients to avoid weight bearing after injection (42.4%). Most of these advised patients to do so for one (16.3%) or two (25.1%) days. As compared to 57.1% of general practitioners and 2.8% of orthopaedic surgeons, 70.7% of rheumatologists advised patients to avoid weight bearing (P < 0.05). Conclusion A significant proportion of rheumatologists and general practitioners performing steroid injections of the knee advise patients not to weight-bear postinjection. Examination of the available literature fails to reveal strong evidence to support such a practice, which has potentially significant implications with regards to loss of working days, costs of mobility aids, and patient inconvenience.