Are Outcomes From an Exercise Therapy and Patient Education Program for Osteoarthritis Associated With Hip and Knee Replacement Within Two Years? A Register‐Based Study of 9,339 Patients With Osteoarthritis
Authors' conclusion
The magnitude of improvement in key measures after exercise therapy and education was significantly associated with the likelihood of surgery. Progression to hip replacement was three times higher than progression to knee replacement.
Study context
- Population
- Patients with clinically diagnosed hip or knee osteoarthritis (OA) in an exercise therapy and patient education program, GLA:D Registry linked to Danish national registries2,304 hip OA, 7,035 knee OA
- Participants
- 2,304 vs 7,035
- Exposure
- Postprogram improvement (baseline to 3-month change) in program outcomes vs time to primary hip or knee replacement
- Hip OAn = 2,304
- Knee OAn = 7,035
- Outcome
- Time to primary hip or knee replacement
- Follow-up
- Two years
Methodological detailsCox proportional hazards models, adjusted HRs per 10-unit improvement
- Cox proportional hazards models
- Adjusted HRs per 10-unit improvement
Main finding
As reported in the abstract
Hip replacement, per 10-unit postprogram improvement
Estimate (95% CI)
Hip OA
aHR (hip-related quality of life) 0.74(0.69–0.80)
Hip OA
aHR (arthritis self-efficacy, pain subscale) 0.90(0.85–0.96)
Per 10-unit postprogram improvement, as printed
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| Knee replacement within 2 years, per 10-unit improvement in program outcomes (knee OA) · two yearsImprovement in knee pain · lower end of range 0.81 to 0.90 · associated with a lower hazard of knee replacement · Cox proportional hazards models | 0.81 (0.76–0.86) | |
| Knee replacement within 2 years, per 10-unit improvement in program outcomes (knee OA) · two yearsImprovement in knee pain · upper end of range 0.81 to 0.90 · associated with a lower hazard of knee replacement · Cox proportional hazards models | 0.90 (0.86–0.95) | |
| Knee replacement within 2 years, per 10-unit improvement in program outcomes (knee OA) · two yearsImprovement in knee-related quality of life · lower end of range 0.70 to 0.79 · associated with a lower hazard of knee replacement · Cox proportional hazards models | 0.70 (0.63–0.78) | |
| Knee replacement within 2 years, per 10-unit improvement in program outcomes (knee OA) · two yearsImprovement in knee-related quality of life · upper end of range 0.70 to 0.79 · associated with a lower hazard of knee replacement · Cox proportional hazards models | 0.79 (0.72–0.86) | |
| Knee replacement within 2 years, per 10-unit improvement in program outcomes (knee OA) · two yearsImprovement in arthritis self-efficacy (pain subscale) · associated with a lower hazard of knee replacement · Cox proportional hazards models | 0.89 (0.83–0.94) | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Are Outcomes From an Exercise Therapy and Patient Education Program for Osteoarthritis Associated With Hip and Knee Replacement Within Two Years? A Register‐Based Study of 9,339 Patients With Osteoarthritis. Arthritis Care Res (Hoboken). Published 15 March 2024. doi:10.
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