Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis: a 10-year population-based case–control study
Authors' conclusion
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.
Study context
- Population
- Knee osteoarthritis (OA) patients from the Skåne Healthcare Register, Sweden5,665 cases, matched 1:1
- Exposure
- Knee OA patients who underwent knee replacement vs matched OA patients without knee replacement
- Casesn = 5,665
- Outcome
- Annual prevalence and prevalence ratio of primary care and physiotherapy visits, dispensed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids (all for any cause)
- Follow-up
- 10 years before knee replacement
Methodological detailsmatched 1:1 by sex, age, time and healthcare level of initial OA diagnosis, Poisson regression
- Matched 1:1 by sex, age, time and healthcare level of initial OA diagnosis
- Poisson regression
Main finding
As reported in the abstract
Prevalence ratio (cases vs controls), year before index date
Each group vs controlsEstimate (95% CI)
Cases
prevalence ratio (physiotherapy use) 1.8(1.7–1.8)
Cases
prevalence ratio (opioid use) 1.6(1.5–1.7)
Cases
prevalence ratio (NSAID use) 1.8(1.7–1.9)
Observational data: associations, not effects.
Further findings
| Outcome | Prevalence ratio (95% CI) | |
|---|---|---|
| NSAID use, 10 years before index date | 1.3 (1.2–1.3) | |
| 0.512Prevalence ratio (log scale) |
NSAID use, 10 years before index date
- NSAID use consistently higher among cases
Original publication
Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis: a 10-year population-based case–control study. RMD Open. Published 22 September 2023. doi:10.
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