Use of Nondrug, Nonoperative Interventions by Community‐Dwelling People With Hip and Knee Osteoarthritis

Abstract

Objective. Guidelines recommend nondrug, nonoperative treatments as the first-line approach for hip and knee osteoarthritis (OA), yet there is limited data regarding use of these treatments in OA. This study describes the use of nondrug, nonoperative interventions in people with hip and knee OA. Methods. A convenience sample of 591 people with hip or knee OA completed a questionnaire indicating their past and/or current use of 17 nondrug, nonoperative interventions each for their hip or knee OA. Descriptive analyses, based on frequency counts and proportions, and chi-square tests described the use of each intervention in the total cohort, and within subgroups of knee and hip OA. Results. Participants were currently using a mean ؎ SD of 0.8 ؎ 0.9 of the strongly recommended interventions. Making efforts to lose weight (50%, n ‫؍‬ 294) and shoe orthoses (30%, n ‫؍‬ 175) were the most common currently used interventions. Strengthening (26%, n ‫؍‬ 152) and stretching exercises (23%, n ‫؍‬ 133) were the most common interventions that participants had tried in the past but were no longer utilizing. Of note, 12% (n ‫؍‬ 71) had never used any of the interventions. Use of 5 treatments (shoe orthoses, heat and/or cold, muscle strengthening exercises, walking aids, and transcutaneous electrical nerve stimulation) was significantly different between the hip and knee cohorts (P < 0.05). Conclusion. Use of nondrug, nonoperative interventions was low among people with hip and knee OA. Our findings show evidence-practice gaps, particularly with respect to the interventions most strongly recommended in clinical guidelines for hip and knee OA (weight loss and exercise).

Factors Influencing Cane Use for the Management of Knee Osteoarthritis: A Cross‐Sectional Survey

“…We found that 35% of people had ever used a cane for their knee pain. This is consistent with our prior research evaluating use of non-pharmacological non-operative treatment strategies in people with hip and knee OA, which showed that 14% of 591 people had used a gait aid (20). Other studies have also reported relatively limited use of canes and other assistive walking devices in patients with OA (9, 10).…”

Barriers and enablers to uptake of a contemporary guideline-based management program for hip and knee osteoarthritis: A qualitative study

“…This study has identified Australian patient and medical professional views on barriers and enablers to participation in, and referral to, a contemporary guideline-based osteoarthritis management program (GLA:D Australia ). Emergent themes confirm findings from previous qualitative literature from both patient [ 15 , [18] , [19] , [20] ] and medical professional [ 16 , [21] , [22] , [23] , [24] ] perspectives about osteoarthritis management programs and the non-surgical components of care, and help to explain the currently limited uptake of guideline-based care for people with osteoarthritis [ [10] , [11] , [12] ]. Based on findings from this study and guided by the theoretical domains framework [ 25 ], our recommendations may help to improve the uptake and participation of guideline-based osteoarthritis management programs.…”

Peoples' beliefs about their chronic hip pain and its care: a systematic review of qualitative studies. “I'm just getting old and breaking down”

“…5,6,20,33,118,88,71,72,77,110 Most people were not managing their hip pain with medications or therapeutic exercise. Rates of healthcare use support this finding: most people with chronic musculoskeletal pain do not adhere to pain medications 80 ; most people have not exercised or have stopped exercising to manage their hip or knee osteoarthritis 55 ; many people with hip pain in general practice care are not referred to nonsurgical treatments. 9 Similar to people with other musculoskeletal problems, 34,80 people with hip pain did not adhere to medications because they were not advised about them (eg, discussing their potential risks and benefits) and because they feared adverse effects, such as tolerance and addiction.…”