Lauren K King1, Deborah A Marshall1, Peter Faris1, Linda J Woodhouse1, C Allyson Jones1, Tom Noseworthy1, Eric Bohm1, Michael J Dunbar1, Gillian A Hawker. 1. From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker@utoronto.ca. Accepted for publication November 5, 2019.
Abstract
OBJECTIVE: Our aim was to assess prior use of core recommended non-surgical treatment among patients with knee osteoarthritis (OA) scheduled for total knee arthroplasty (TKA), and to assess potential patient-level correlates of underuse, if found. METHODS: This was a cross-sectional study of patients undergoing TKA for primary knee OA at 2 provincial central intake hip and knee clinics in Alberta, Canada. Standardized questionnaires assessed sociodemographic characteristics, social support, coexisting medical conditions, OA symptoms and coping, and previous non-surgical management. Multivariable logistic regression was used to assess the patient-level variables independently associated with receipt of recommended non-surgical knee OA treatment, defined as prior use of pharmacotherapy for pain, rehabilitation strategies (exercise or physiotherapy), and weight loss if overweight or obese (body mass index ≥ 25 kg/m2). RESULTS: There were 1273 patients included: mean age 66.9 years (SD 8.7), 39.9% male, and 44.1% had less than post-secondary education. Recommended non-surgical knee OA treatment had been used by 59.7% of patients. In multivariable modeling, the odds of having received recommended non-surgical knee OA treatment were significantly and independently lower among individuals who were older (OR 0.97, 95% CI 0.95-0.99), male (OR 0.33, 0.25-0.45), and who lacked post-secondary education (OR 0.70, 0.53-0.93). CONCLUSION: In a large cross-sectional analysis of knee OA patients scheduled for TKA, 40% of individuals reported having not received core recommended non-surgical treatments. Older individuals, men, and those with less education had lower odds of having used recommended non-surgical OA treatments.
OBJECTIVE: Our aim was to assess prior use of core recommended non-surgical treatment among patients with knee osteoarthritis (OA) scheduled for total knee arthroplasty (TKA), and to assess potential patient-level correlates of underuse, if found. METHODS: This was a cross-sectional study of patients undergoing TKA for primary knee OA at 2 provincial central intake hip and knee clinics in Alberta, Canada. Standardized questionnaires assessed sociodemographic characteristics, social support, coexisting medical conditions, OA symptoms and coping, and previous non-surgical management. Multivariable logistic regression was used to assess the patient-level variables independently associated with receipt of recommended non-surgical knee OA treatment, defined as prior use of pharmacotherapy for pain, rehabilitation strategies (exercise or physiotherapy), and weight loss if overweight or obese (body mass index ≥ 25 kg/m2). RESULTS: There were 1273 patients included: mean age 66.9 years (SD 8.7), 39.9% male, and 44.1% had less than post-secondary education. Recommended non-surgical knee OA treatment had been used by 59.7% of patients. In multivariable modeling, the odds of having received recommended non-surgical knee OA treatment were significantly and independently lower among individuals who were older (OR 0.97, 95% CI 0.95-0.99), male (OR 0.33, 0.25-0.45), and who lacked post-secondary education (OR 0.70, 0.53-0.93). CONCLUSION: In a large cross-sectional analysis of knee OApatients scheduled for TKA, 40% of individuals reported having not received core recommended non-surgical treatments. Older individuals, men, and those with less education had lower odds of having used recommended non-surgical OA treatments.
Authors: Armaghan Mahmoudian; L Stefan Lohmander; Ali Mobasheri; Martin Englund; Frank P Luyten Journal: Nat Rev Rheumatol Date: 2021-08-31 Impact factor: 20.543
Authors: Thomas J Schnitzer; Rebecca L Robinson; Leslie Tive; Joseph C Cappelleri; Andrew G Bushmakin; James Jackson; Mia Berry; Sophie Barlow; Chloe Walker; Lars Viktrup Journal: BMC Musculoskelet Disord Date: 2022-05-26 Impact factor: 2.562