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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 LU ; Hellberg, Clara LU ; Turkiewicz, Aleksandra LU ; Appleyard, Tom ; Yu, Dahai ; Thomas, Geraint ; Peat, George and Englund, Martin LU orcid (2023) In RMD Open 9(3).
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... (More)

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.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, Osteoarthritis, Knee, Rehabilitation
in
RMD Open
volume
9
issue
3
article number
e003422
publisher
BMJ Publishing Group
external identifiers
  • pmid:37739449
  • scopus:85172425585
ISSN
2056-5933
DOI
10.1136/rmdopen-2023-003422
language
English
LU publication?
yes
id
6276b36e-d140-4d6f-b616-0a888ed537ff
date added to LUP
2023-12-18 09:06:20
date last changed
2024-04-16 21:17:28
@article{6276b36e-d140-4d6f-b616-0a888ed537ff,
  abstract     = {{<p>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.</p>}},
  author       = {{Dell'Isola, Andrea and Hellberg, Clara and Turkiewicz, Aleksandra and Appleyard, Tom and Yu, Dahai and Thomas, Geraint and Peat, George and Englund, Martin}},
  issn         = {{2056-5933}},
  keywords     = {{Epidemiology; Osteoarthritis, Knee; Rehabilitation}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{3}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{RMD Open}},
  title        = {{Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis : A 10-year population-based case-control study}},
  url          = {{http://dx.doi.org/10.1136/rmdopen-2023-003422}},
  doi          = {{10.1136/rmdopen-2023-003422}},
  volume       = {{9}},
  year         = {{2023}},
}