INTRODUCTION: The purpose of this study was to determine if a multimodal programme including physiotherapy and education could improve the symptoms of osteoarthritis of the knee across various severities of disease. PATIENTS AND METHODS: Seventy-two patients with osteoarthritis of the knee confirmed on radiographic evidence were referred over a 13-month period for a lower limb programme which consisted of 12 classes over 6 weeks of group physiotherapy and included education on osteoarthritis, diet and exercise. Six patients went on to have joint arthroplasty at a mean time of 6.5 months with three placed on the waiting list during follow-up. RESULTS: Pre-intervention, the mean WOMAC score was 42.0 and the mean Oxford Knee Score was 32.8. Post-intervention at a mean follow-up of 12 months, the mean WOMAC score was 31.6 and the mean Oxford Knee Score 24.3. The change in scores following intervention was statistically significant (P < 0.01). Using the WOMAC scoring system, the greatest effect size was seen in patients with Kellgren-Lawrence grade IV whilst using the Oxford knee scoring system, the greatest effect size was seen in patients with Kellgren-Lawrence grade II. CONCLUSIONS: At 12 months, a multimodal programme of non-operative interventions has an excellent impact upon the symptoms of osteoarthritis of the knee with improved patient-reported scores. The level of improvement cannot be inferred from the radiographic grade of osteoarthritis. This modality could be considered for all patients with mild-to-moderate osteoarthritis of the knee.
INTRODUCTION: The purpose of this study was to determine if a multimodal programme including physiotherapy and education could improve the symptoms of osteoarthritis of the knee across various severities of disease. PATIENTS AND METHODS: Seventy-two patients with osteoarthritis of the knee confirmed on radiographic evidence were referred over a 13-month period for a lower limb programme which consisted of 12 classes over 6 weeks of group physiotherapy and included education on osteoarthritis, diet and exercise. Six patients went on to have joint arthroplasty at a mean time of 6.5 months with three placed on the waiting list during follow-up. RESULTS: Pre-intervention, the mean WOMAC score was 42.0 and the mean Oxford Knee Score was 32.8. Post-intervention at a mean follow-up of 12 months, the mean WOMAC score was 31.6 and the mean Oxford Knee Score 24.3. The change in scores following intervention was statistically significant (P < 0.01). Using the WOMAC scoring system, the greatest effect size was seen in patients with Kellgren-Lawrence grade IV whilst using the Oxford knee scoring system, the greatest effect size was seen in patients with Kellgren-Lawrence grade II. CONCLUSIONS: At 12 months, a multimodal programme of non-operative interventions has an excellent impact upon the symptoms of osteoarthritis of the knee with improved patient-reported scores. The level of improvement cannot be inferred from the radiographic grade of osteoarthritis. This modality could be considered for all patients with mild-to-moderate osteoarthritis of the knee.
Authors: Coen H van Gool; Brenda W J H Penninx; Gertrudis I J M Kempen; W Jack Rejeski; Gary D Miller; Jacques Th M van Eijk; Marco Pahor; Stephen P Messier Journal: Arthritis Rheum Date: 2005-02-15
Authors: W Zhang; R W Moskowitz; G Nuki; S Abramson; R D Altman; N Arden; S Bierma-Zeinstra; K D Brandt; P Croft; M Doherty; M Dougados; M Hochberg; D J Hunter; K Kwoh; L S Lohmander; P Tugwell Journal: Osteoarthritis Cartilage Date: 2008-02 Impact factor: 6.576
Authors: M V Hurley; N E Walsh; H L Mitchell; T J Pimm; E Williamson; R H Jones; B C Reeves; P A Dieppe; A Patel Journal: Arthritis Rheum Date: 2007-10-15