Misconceptions and the Acceptance of Evidence-based Nonsurgical Interventions for Knee Osteoarthritis. A Qualitative Study

Review written by Dr Jarod Hall info

Key Points

  1. The findings of this study demonstrate that the majority of people seeking total knee replacement have maladaptive beliefs and fear avoidance behaviors that conflict with the general consensus found in the literature in regard to osteoarthritis.
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BACKGROUND & OBJECTIVE

Osteoarthritis (OA) is the most prevalent joint disease and a leading source for which chronic pain and disability in the United States is attributed. Knee OA accounts for more than 80% of the disease’s total burden and affects at least 19% of American adults aged 45 years and older (1,2). Evidence-based nonsurgical interventions such as weight loss and exercise can reduce pain and disability associated with knee OA, and best-practice guidelines recommend that such interventions should be underpinned by behavior changes, in addition to nonopioid medications (3,4).

Despite the robust evidence that engaging in a nonsurgical intervention plan can delay or even avoid the need for surgery in most patients with moderate-to-severe knee OA, data demonstrates that patient care is often at odds with this evidence and that most people living with OA have not attempted an exercise-based strategy or weight loss program to alleviate symptoms and improve function (3). The aim of this study was to investigate patient-related cognitive factors such as beliefs and attitudes toward knee OA and its treatment.

Evidence-based nonsurgical interventions such as weight loss and exercise can reduce pain and disability associated with knee OA.
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The beliefs expressed by patients are in stark contrast to what we would hope when considering the growing body of evidence which has demonstrated the positive impact of weight bearing and resistance training.

METHODS

Patients on the waiting list for total knee arthroplasty (TKA) attending the orthopedic pre-admission clinic at a large tertiary hospital in Australia were approached to participate in this study. The sample comprised of 27 patients, of whom 48% women, and

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