BACKGROUND: Efficient approaches are needed for delivering non-pharmacological interventions for knee osteoarthritis (OA). OBJECTIVE: This trial compared group-based versus individual physical therapy (PT) interventions for knee OA. DESIGN AND METHODS: 320 patients with knee OA at the VA Medical Center in Durham, NC (mean age 60 years, 88% male; 58% non-white) were randomized to either the group intervention (GPT; six one-hour sessions, typically eight participants/group) or the individual intervention (IPT; two one-hour sessions). Both programs included instruction in home exercise, joint protection techniques and individual physical therapist evaluation. The primary outcome was the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC; range 0 to 96, higher scores indicate worse symptoms), measured at baseline, 12 weeks and 24 weeks. The secondary outcome was the Short Performance Physical Battery (SPPB; range 0 to 12, higher scores indicate better performance), measured at baseline and 12 weeks. Linear mixed models assessed the difference in WOMAC scores between arms. RESULTS: At 12-weeks, WOMAC scores were 2.7 points lower in GPT versus IPT (95% confidence interval (CI) -5.9 to 0.5; p = 0.10), indicating no between-group difference. At 24-weeks, WOMAC scores were 1.3 points lower in GPT versus IPT (95% CI -4.6 to 2.0; p = 0.44), indicating no significant between-group difference. At 12-weeks, SPPB scores were 0.1 points lower in the GPT arm versus IPT (95% CI -0.5 to 0.2, p = 0.53), indicating no difference between groups. LIMITATIONS: This study was conducted in one VA Medical Center. Outcome assessors were blinded, but participants and physical therapists were not. CONCLUSIONS: GPT was not more effective than IPT for primary or secondary study outcomes. Either GPT or IPT may be reasonable delivery models for health care systems to consider.

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