Five-year follow-up of patients with knee osteoarthritis not eligible for total knee replacement: results from a randomised trial

Larsen, Jesper Bie; Roos, Ewa M.; Laursen, Mogens Berg; Holden, Sinéad; Johansen, Martin Berg; Rathleff, Michael Skovdal; Arendt‐Nielsen, Lars; Rasmussen, Sten; Skou, Søren Thorgaard

doi:10.1136/bmjopen-2021-060169

Cited by 8 publications

(2 citation statements)

References 40 publications

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“…The 5-year TKR incidence rate that was found in the study was 18.4%, which is significantly lower than the natural decay rate reported among patients presenting with similar symptoms [26][27][28]. As a conservative comparison, Larsen, et al demonstrated a 30% to 34% TKR incidence over five years among newly diagnosed patients with knee OA who were not initially eligible for surgery [25].…”

Section: Discussioncontrasting

confidence: 51%

Untitled

2023

J Musculoskelet Disord Treat

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Background: Chronic knee pain, primarily associated with knee osteoarthritis (OA), is a leading cause of disability among older adults and place an immense burden on patients and healthcare systems, exceeding $80 billion in direct medical costs annually. Current non-surgical solutions to treat chronic knee pain provide limited relief of symptoms. The present study aims to assess the long-term effect of a biomechanical, non-invasive intervention on total knee replacement (TKR) incidence and the utilization of healthcare resources over five years. Methods:This was a retrospective study among older adults with chronic knee pain, primarily due to OA, who received the biomechanical intervention between 2014 and 2017. An independent survey institute contacted patients between August and September 2022 to confirm their surgical status and utilization of other healthcare services, covering at least five years of follow-up. During the intervention, patients were provided with a FDA-cleared shoe-like device, which includes two convex pods attached to the sole. The pods are attached to the shoe in a customized manner based on the patient's gait and pain (i.e., calibrated). The device shifts the foot's center of pressure to reduce the knee joint load and alleviate pain. The device also creates controlled perturbation that challenges gait and posture stability and creates neuromuscular training. Patients were instructed to wear the device for up to 2-3 hours a day during their daily routine and invited to follow-up sessions for treatment modifications.Results: Four hundred and fourteen patients responded to the survey. Their mean (SD) age was 66.5 (4.2) years, 65% were women and 82% of patients were diagnosed with knee OA. At five years since inception, the TKR incidence rate was 18.4% with 95% CI (14.6%, 22.1%). Most responders (79%) reported using other healthcare resources and services to treat their knee pain before the intervention. Of them, 64% ceased receiving intra-articular injections to the knee, 44% discontinued using pain medication and 46% stopped receiving physiotherapy. Conclusion:This biomechanical, non-invasive intervention is a beneficial and sustainable intervention that reduces healthcare resource utilization, including avoidance of TKR and chronic knee pain. With the constant increase in the prevalence of chronic knee pain, offering this intervention to patients can help address the increasing burden on the healthcare system and society.

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Section: Discussioncontrasting

confidence: 51%

Untitled

2023

J Musculoskelet Disord Treat

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“…This enhances treatment efficacy and aids in refining patient selection criteria, optimising resource utilisation, and minimising potential risks. Identifying biomarkers is critical for tailoring regenerative therapies to individual patient profiles, ultimately improving overall treatment outcomes [ 47 ].…”

Section: Reviewmentioning

confidence: 99%

Navigating the Therapeutic Landscape: A Comprehensive Review of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate in Knee Osteoarthritis

Balusani,

Shrivastava,

Pundkar

et al. 2024

Cureus

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This comprehensive review provides an in-depth analysis of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) as potential treatments for knee osteoarthritis. It explores their mechanisms of action, clinical efficacy, safety considerations, and the importance of personalised treatment approaches. The review highlights promising findings regarding the ability of PRP and BMAC to alleviate symptoms, improve joint function, and potentially slow disease progression. It emphasises the need for further research into long-term outcomes, direct comparative studies, protocol standardisation, biomarker identification, and cost-effectiveness assessments to enhance clinical practice. While the review does not directly compare PRP and BMAC, it provides valuable insights into their respective roles in knee osteoarthritis management. The review aims to contribute to evidence-based advancements in regenerative therapies for knee osteoarthritis by addressing critical research priorities and refining treatment strategies.

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