Skip to main content

Research Repository

Advanced Search

Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis: a 10-year population-based case–control study

Dell'Isola, Andrea; Hellberg, Clara; Turkiewicz, Aleksandra; Appleyard, Tom; Yu, Dahai; Thomas, Geraint; Peat, George; Englund, Martin

Authors

Andrea Dell'Isola

Clara Hellberg

Aleksandra Turkiewicz

Tom Appleyard

Geraint Thomas

George Peat

Martin Englund



Abstract

Aim: To investigate temporal trends in primary care visits, physiotherapy visits, dispensed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in knee osteoarthritis (OA) patients who have and have not undergone knee replacement.

Methods: We analysed 5665 OA patients from the Skåne Healthcare Register, Sweden, who underwent knee replacement between 2015 and 2019. Controls were OA patients without knee replacement, matched 1:1 by sex, age, time and healthcare level of initial OA diagnosis, and assigned a pseudo-index date corresponding to their case’s knee replacement date. Annual prevalence and prevalence ratio of primary care and physiotherapy visits, dispensed NSAIDs and opioids (all for any cause) in the 10 years before knee replacement were estimated using Poisson regression.

Results: The annual prevalence of all-cause primary care visits, physiotherapy visits and opioid use was similar between cases and controls until 3 years before the index date when it started to increase among the cases. The year before the index date, the prevalence ratio (cases vs controls) for physiotherapy use was 1.8 (95% CI 1.7, 1.8), while for opioid use 1.6 (1.5, 1.7). NSAID use was consistently higher among cases, even 10 years before the index date when the prevalence ratio versus controls was 1.3 (1.2, 1.3), increasing to 1.8 (1.7, 1.9) in the year preceding the index date.

Conclusions: Management of OA patients who have and have not undergone knee replacement appears largely similar except for higher use of NSAIDs in knee replacement cases. Symptomatic treatments start to increase a few years before the surgery in knee replacement cases.

Journal Article Type Article
Acceptance Date Aug 22, 2023
Online Publication Date Sep 22, 2023
Publication Date Sep 1, 2023
Deposit Date Oct 6, 2023
Publicly Available Date Oct 6, 2023
Journal RMD Open
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 9
Issue 3
Article Number e003422
DOI https://doi.org/10.1136/rmdopen-2023-003422
Keywords Epidemiology, Osteoarthritis, Knee, Rehabilitation

Files

Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis: a 10-year population-based case–control study (270 Kb)
Archive

Licence
https://creativecommons.org/licenses/by-nc/4.0/

Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/

Copyright Statement
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.





You might also like



Downloadable Citations