OBJECTIVE: Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients. DESIGN: Randomised, assessor-blinded, controlled trial. SETTING: Primary care. SUBJECTS: Patients with clinically verified hip or knee osteoarthritis, < 150 min/week with moderate or vigorous physical activity, aged 40 to 74. INTERVENTION: The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups. MAIN MEASURES: Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months. RESULTS: There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74 to 130) minutes/week at baseline to 214 (95% CI 183 to 245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103 to 157) to 176 (95% CI 145 to 207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by -514 (95% CI -567 to 462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was -852 (95% CI -900 to 804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5 to 8.2) and in the prescription group by 14.7 points (95% CI 14.3 to 15.1) from baseline to 24 months (p = 0.024 between groups). CONCLUSIONS: There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis.

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