A survey to explore the current use of injection therapy as part of a conservative treatment plan for degenerative meniscal lesions within UK based, injection trained physiotherapy members of the society of musculoskeletal medicine

Abstract

Objectives: To explore the current use of injection therapy as part of a conservative treatment plan for degenerative meniscal lesions (DML) within UK based physiotherapy members of the Society of Musculoskeletal Medicine (SOMM) with injection training.

Methods: An online survey was distributed via email to all UK based, SOMM physiotherapists who had trained and received their injection diploma through the SOMM (n = 203) with a response rate of 32% (n = 64). The data were analysed using descriptive statistics, contingency tables and the Fisher's exact test. A P value ≤0.05 was considered significant. Ethical clearance was gained through the SOMM and Middlesex University.

Results: Of the respondents 98% (n = 62) of current UK based, injection trained SOMM physiotherapists utilize conservative treatment for DML of which 81% (n = 52) include injection therapy. Seventy-seven per cent (n = 49) who currently use injection therapy for DML administer a combination of 40 mg Depomedrone combined with local anaesthetic via a patellofemoral approach. Those not using injection therapy as part of their management of DML attributed this to local department restrictions and lack of evidence.

Discussion: This research has helped further understand the use of injection therapy for DML and where it fits within a conservative treatment plan. The benefit from injection therapy reported by respondents is similar to previous research but could be influenced by injection exposure and potentially steroid choice. Overall a consensus is starting to appear regarding dosage, steroid, and administration; however, differences arise when comparing individual department guidelines to CSP and NICE guidelines.

Keywords:

• Injection therapy
• Steroid
• Degenerative meniscal lesion
• Conservative treatment
• Society of Musculoskeletal Medicine
• SOMM
• Physiotherapist

Acknowledgements

Thank you to my family for their support, Gordon and Kay for your guidance and expertise, and all physiotherapists that took part in the research.

Disclaimer statements

Contributors Kay and Gordon were my academic and clinical tutors through my MSc dissertation and providing help for this submission.

Funding This was a self-funded MSc research project, with my employer providing paid time off to complete.

Conflicts of interest Stated author G. Smith is a current Fellow of The Society of Musculoskeletal Medicine.

Ethics approval Ethical approval was gained through SOMM and Middlesex University in 2015.