DOS 2017

· DOS Abstracts

Limited use of the orthopaedic surgeon’s advice on

non-surgical treatment for knee osteoarthritis – An

observational cohort study.

Sofie Ryaa, Lina H. Ingelsrud, Søren T. Skou, Ewa M. Roos, Anders Troelsen

Department of Orthopaedic surgery, Copenhagen University Hospital Hvidovre

Background:

The Good Life with osteoArthritis in Denmark (GLA:D) pro-

gramme consists of patient education and supervised exercise therapy and ad-

heres to clinical guidelines for knee osteoarthritis (OA). Non-operative treat-

ments like GLA:D may be beneficial when surgery is not considered timely.

Purpose / Aim of Study:

To present the clinical course of action taken by pa-

tients advised to participate in GLA:D by an orthopaedic surgeon before decid-

ing on undergoing knee replacement.

Materials and Methods:

Patient records from all patients with knee OA con-

sulting one orthopaedic surgeon in 2015 were reviewed to detect those be-

ing advised GLA:D participation. Radiologic OA was classified with Kellgren-

Lawrence (KL) grade 0-4, none-severe. Results after 3 months were extracted

from the GLA:D database, including a visual analogue scale (VAS) for knee pain

(0-100, best-worst), and the Knee injury and Osteoarthritis Outcome score

knee-related quality of life (QOL) subscale (0-100, worst-best).

Findings / Results:

Out of 142 patients with primary referrals due to knee OA,

83 (58.5%) were advised to participate in GLA:D. They had a mean (SD) age

of 65.0 (10.7) and 59 (62.8%) were female. They were either not eligible for

surgery, or pending surgical decision and 34 (44.8%) had a KL grade 3-4. Only

18 (22%) patients participated in GLA:D, and 14 (17%) completed 3 months

follow-up. For these patients, the mean (SD) VAS pain score improved from

61.4 (18.6) to 42.7 (25.1) (p<0.001), while knee-related QOL remained un-

changed (from 41.5 (16.2) to 43.8 (12.3) (p=0.535)).

Conclusions:

The majority of patients did not follow the surgeon’s advice on

non-surgical treatment. In those who did the significant pain reduction found

indicates patient education and supervised exercise therapy being beneficial in

patients prior to deciding on knee replacement, or if surgery is not indicated.

No conflicts of interest reported

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