Exercise and education vs intra-articular saline for knee osteoarthritis: A 1-year follow-up of a randomized trial

8 Citations (Scopus)


OBJECTIVE: To assess the longer-term effect of the Good Life with osteoarthritis in Denmark (GLAD) exercise and education program relative to open-label placebo (OLP) on changes from baseline in core outcomes in individuals with knee osteoarthritis (OA).

METHODS: In this 1-year follow-up of an open-label, randomized trial, patients with symptomatic and radiographically confirmed knee OA were monitored after being randomized to either the 8-week GLAD program or OLP given as 4 intra-articular saline injections over 8 weeks. The primary outcome was the change from baseline in the Knee injury and Osteoarthritis Outcome Score questionnaire (KOOS) pain subscale after 1 year in the intention-to-treat population. Key secondary outcomes were the KOOS function and quality of life subscales, and Patients' Global Assessment of disease impact.

RESULTS: 206 adults were randomly assigned: 102 to GLAD and 104 to OLP, of which only 137 (63/74 GLAD/OLP) provided data at 1 year. At one year the mean changes in KOOS pain were 8.4 for GLAD and 7.0 for OLP (Difference: 1.5 points; 95% CI -2.6 to 5.5). There were no between-group differences in any of the secondary outcomes.

CONCLUSIONS: In this 1-year follow-up of individuals with knee OA, the 8-week GLAD program and OLP both provided minor longer-term benefits with no group difference. These results require confirmation given the significant loss to follow-up.


Original languageEnglish
JournalOsteoarthritis and Cartilage
Issue number5
Pages (from-to)627-635
Number of pages9
Publication statusPublished - May 2023


  • Adult
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Osteoarthritis, Knee
  • Pain/drug therapy
  • Quality of Life
  • Treatment Outcome
  • Knee
  • Long-term
  • Subgroup
  • Exercise, education
  • Open-label placebo
  • Osteoarthritis


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