Cargando…

Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis

BACKGROUND AND PURPOSE: The discrepancy between symptoms and radiographic severity of knee osteoarthritis (OA) is well described. However, little is known about whether radiographic severity is predictive of the clinical result of nonoperative treatment. We investigated whether radiographic severity...

Descripción completa

Detalles Bibliográficos
Autores principales: Skou, Søren T, Derosche, Christina A, Andersen, Mikkel M, Rathleff, Michael S, Simonsen, Ole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4564783/
https://www.ncbi.nlm.nih.gov/pubmed/25765729
http://dx.doi.org/10.3109/17453674.2015.1029392
_version_ 1782389499669512192
author Skou, Søren T
Derosche, Christina A
Andersen, Mikkel M
Rathleff, Michael S
Simonsen, Ole
author_facet Skou, Søren T
Derosche, Christina A
Andersen, Mikkel M
Rathleff, Michael S
Simonsen, Ole
author_sort Skou, Søren T
collection PubMed
description BACKGROUND AND PURPOSE: The discrepancy between symptoms and radiographic severity of knee osteoarthritis (OA) is well described. However, little is known about whether radiographic severity is predictive of the clinical result of nonoperative treatment. We investigated whether radiographic severity and treatment type were associated with improvements in pain after nonoperative treatment of patients with knee OA. PATIENTS AND METHODS: A 5-year consecutive series of patients deemed not eligible for total knee arthroplasty (TKA) by an experienced orthopedic surgeon was contacted 1–5 years later. Radiographic severity, age, sex, and BMI were registered at the consultation. At follow-up, patients were asked to answer a questionnaire on type of treatment and improvements in pain after treatment. RESULTS: Of 1,848 patients who were not eligible for TKA, 1,414 (77%) completed the follow-up questionnaire (mean age 66 (24–96) years; 55% women). Radiographic severity was not associated with improvements in pain even after adjusting for treatment type, age, sex, and BMI (p > 0.1). The odds ratio of improvement was higher by a factor of 2 in patients who received physiotherapy or multimodal treatment than in patients who did not. INTERPRETATION: Radiographic severity was not associated with improvements in pain after nonoperative treatment. Patients who are not eligible for TKA can confidently be referred to nonoperative treatment even if they have severe radiographic OA. The treatment should preferably be multimodal, including physiotherapy, as recommended in Danish and international clinical guidelines.
format Online
Article
Text
id pubmed-4564783
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Informa Healthcare
record_format MEDLINE/PubMed
spelling pubmed-45647832015-10-01 Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis Skou, Søren T Derosche, Christina A Andersen, Mikkel M Rathleff, Michael S Simonsen, Ole Acta Orthop Knee/Ankle BACKGROUND AND PURPOSE: The discrepancy between symptoms and radiographic severity of knee osteoarthritis (OA) is well described. However, little is known about whether radiographic severity is predictive of the clinical result of nonoperative treatment. We investigated whether radiographic severity and treatment type were associated with improvements in pain after nonoperative treatment of patients with knee OA. PATIENTS AND METHODS: A 5-year consecutive series of patients deemed not eligible for total knee arthroplasty (TKA) by an experienced orthopedic surgeon was contacted 1–5 years later. Radiographic severity, age, sex, and BMI were registered at the consultation. At follow-up, patients were asked to answer a questionnaire on type of treatment and improvements in pain after treatment. RESULTS: Of 1,848 patients who were not eligible for TKA, 1,414 (77%) completed the follow-up questionnaire (mean age 66 (24–96) years; 55% women). Radiographic severity was not associated with improvements in pain even after adjusting for treatment type, age, sex, and BMI (p > 0.1). The odds ratio of improvement was higher by a factor of 2 in patients who received physiotherapy or multimodal treatment than in patients who did not. INTERPRETATION: Radiographic severity was not associated with improvements in pain after nonoperative treatment. Patients who are not eligible for TKA can confidently be referred to nonoperative treatment even if they have severe radiographic OA. The treatment should preferably be multimodal, including physiotherapy, as recommended in Danish and international clinical guidelines. Informa Healthcare 2015-10 2015-09-04 /pmc/articles/PMC4564783/ /pubmed/25765729 http://dx.doi.org/10.3109/17453674.2015.1029392 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open-access article distributed under the terms of the CC-BY-NC-ND 3.0 License which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is credited.
spellingShingle Knee/Ankle
Skou, Søren T
Derosche, Christina A
Andersen, Mikkel M
Rathleff, Michael S
Simonsen, Ole
Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis
title Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis
title_full Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis
title_fullStr Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis
title_full_unstemmed Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis
title_short Nonoperative treatment improves pain irrespective of radiographic severity: A cohort study of 1,414 patients with knee osteoarthritis
title_sort nonoperative treatment improves pain irrespective of radiographic severity: a cohort study of 1,414 patients with knee osteoarthritis
topic Knee/Ankle
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4564783/
https://www.ncbi.nlm.nih.gov/pubmed/25765729
http://dx.doi.org/10.3109/17453674.2015.1029392
work_keys_str_mv AT skousørent nonoperativetreatmentimprovespainirrespectiveofradiographicseverityacohortstudyof1414patientswithkneeosteoarthritis
AT deroschechristinaa nonoperativetreatmentimprovespainirrespectiveofradiographicseverityacohortstudyof1414patientswithkneeosteoarthritis
AT andersenmikkelm nonoperativetreatmentimprovespainirrespectiveofradiographicseverityacohortstudyof1414patientswithkneeosteoarthritis
AT rathleffmichaels nonoperativetreatmentimprovespainirrespectiveofradiographicseverityacohortstudyof1414patientswithkneeosteoarthritis
AT simonsenole nonoperativetreatmentimprovespainirrespectiveofradiographicseverityacohortstudyof1414patientswithkneeosteoarthritis