Background Osteoarthritis (OA) of the hip and knee is one of the most common diagnoses in primary care, about 7% of the population in Sweden over 45 years is seeking outpatient care at least once during a five-years period for their problems (1). According to both international and national guidelines (2-4) should all persons with early signs of OA obtain basic treatment including education, advice on weight loss, physical activity and exercise. There is a lack of studies evaluating structured non-surgical treatment of knee and hip OA with patient-reported measuring instruments. Most studies include only knee osteoarthritis and have focused largely on elderly persons.
Objectives Primary object to evaluate treatment with osteoarthritis school for persons with hip or knee OA using patient-reported measuring instruments as outcome. Secondary objective to examine whether age and gender influence the outcome.
Methods A clinical study with statistical analysis estimated at 239 participants, 156 with knee OA (101 women/55 men) and 83 with hip OA (42 women/41 men). Age 40-85 years and the average age was 64.1. Intervention was structured osteoarthritis school with three theory sessions and a six-week training period (5). Follow-up at three months. Evaluation included self-reported outcomes (KOOS/HOOS); pain, symptoms, Activities of Daily Living (ADL), sports/recreation and Quality Of Life (QoL). Can be found on http://www.koos.nu
Results Persons with knee OA were significantly improved in all KOOS subscales and persons with hip OA in HOOS subscales pain and symptoms. Women had better effect than men. Younger persons with knee OA had better effect on Quality of Life. In hip OA, younger persons had better effect in all subscales except ADL.
Conclusions Osteoarthritis school provides significant improvement in persons with knee OA while the effect on hip OA is less evident and more variable. Women with knee OA, 65 and younger, appear to benefit most from osteoarthritis school and KOOS Quality of Life is the subscale that improves the most.
BOA-registret: Årsrapport 2013. Tillgänglig:http//www.boaregistret.se (2014-10-03).
Socialstyrelsen. Nationella riktlinjer höft och knäartros. Tillgänglig: http://www.socialstyrelsen.se/nationellariktlinjerforrorelseorganenssjukdomar (2014-09-29).
Fernandes L, Hagen KB, Biijlsma JWJ et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72:1125-35.
Zhang W, Nuki G, Moskowitz S et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidenced-based, expert consensus guidelines. Ostearthritis and Cartilage. 2008;16(2):137-62.
Thorstensson CA, Garellick G, Rystedt H, Dahlberg LE. Better management of patients with osteoarthritis. Development and nationwide implementation of an evidence-based supported osteoarthritis self-management programme. Musculoskeletal Care.2014;in press.
Disclosure of Interest None declared