Evidence-based tailored conservative treatment of knee and hip osteoarthritis: between knowing and doing

Abstract

Evidence-based multimodal conservative treatment using a standardized protocol for knee and/or hip OA is feasible and successful in 47% of patients. In general, response could not be predicted. Basic first-line recommended conservative treatment options have not been used adequately prior to referral to secondary care in the vast majority of patients.

The efficacy of 12 weeks non-surgical treatment for patients not eligible for total knee replacement: a randomized controlled trial with 1-year follow-up

“…The second leaflet (two pages) contains information on where in region you can seek advice regarding treatment and general information on how to sustain a healthy lifestyle (focusing on diet, smoking, alcohol and physical activity). Content provided to the usual care group was prepared to reflect current treatment of patients with knee OA in clinical practice, found to be suboptimal compared to clinical guidelines in several countries 15,16 .…”

“Beating osteoARThritis”: Development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis

“…However, treatment options proposed in later steps could be offered, if considered appropriate. Also, it has been reported that almost half of the patients referred to secondary care because of OA benefited from a stepped care approach and no predictors for response to non-surgical treatment options could be identified [10]. Therefore, in our opinion, despite the risk for delay of more advanced treatment, the stepped care strategy is a suitable approach for patients with knee or hip OA.…”

“…This explanation is supported by the findings that only 28% of OA patients who are scheduled to undergo total hip arthroplasty had actually ever been referred to a physical therapist during their OA history [6], and that non-pharmacological treatment options, such as patient education, weight reduction and exercise therapy are underutilized [7][8][9][10].…”

Clinical Prediction Models for Patients With Nontraumatic Knee Pain in Primary Care: A Systematic Review and Internal Validation Study

“…The data of these outcome measures were reported in frequencies, percentages, means, or medians. In 6 (37.5%) of the studies, the predictors were dichotomized, 6,10,18,19,27,36 and in 6 (37.5%) of the studies 10,21,27,30,34,36 the number of cases (and noncases) in the multivariate analysis was not at least 10 times the number of independent predictors included in the multivariate analysis. We considered 11 studies to be of sufficient quality.…”

“…Most of the studies (n = 10) were conducted in a primary care setting. 6,15,16,18,19,27,30,34,39,41 One study recruited patients from a military population, 10 2 studies from rehabilitation centers, 36,42 and 3 studies were community based. 2,21,28 The sample sizes of the studies varied from 54 to 1021 patients, with a mean sample size of 409.…”