Abstract
Compare baseline characteristics and change in outcomes in patients with symptomatic knee or hip OA participating in patient education and exercise therapy. Longitudinal cohort study. Good Life with osteoArthritis in Denmark (GLA:D®) is an 8-week patient education and supervised exercise program delivered by certified clinicians. Changes in pain intensity, Knee injury/Hip disability Osteoarthritis Outcome Scores' subscale Quality of Life (K/HOOS QOL), EuroQoL 5-Dimensions 5-Level (EQ-5D) and 40m walk test at ∼3 and 12 months were compared between knee and hip patients. 24,241 knee and 8,358 hip patients were included, with response rates of 75% and 60% at ∼3 and 12 months. Age, gender, symptom duration, pain medication use, pain intensity, physical function and quality of life were alike. More knee than hip patients were obese and had bilateral symptoms. At 3 months, clinically relevant improvements were seen in both knee and hip OA patients with clinically irrelevant between groups differences; 2.1 (1.5; 2.8) mm in pain intensity,-1.1 (-1.5;-0.7) point in K/HOOS QOL score,-0.010 (-0.013;-0.007) in EQ-5D index score and-0.02 (-0.02;-0.01) m/sec in walking speed. At 12 months the slight immediate differences were equalized. Patients presenting with knee and hip OA in primary care were on average more alike than different. Following treatment, clinically relevant improvements were seen in both knee and hip OA patients at 3 and 12 months. Patients with knee and hip OA should be prioritized alike for treatment with patient education and supervised exercise therapy.
Highlights
Osteoarthritis (OA) affects 528 million people worldwide with the greatest burden due to OA of the knee and hip 1
Journal Pre-proof Exercise therapy is a cornerstone in OA treatment, and systematic reviews of the available data from randomized trials suggest the pain-relieving effect immediately after the treatment being larger in patients with knee OA, effect size -0.49 [-0.59, -0.39] 4, compared to hip OA, effect size -0.38 [0.55, -0.20] 5
It is only few of the trials included in these systematic reviews that have included both patients with knee or hip OA, which would allow for a direct comparison of treatment result 6-10
Summary
Osteoarthritis (OA) affects 528 million people worldwide with the greatest burden due to OA of the knee and hip 1. Journal Pre-proof Exercise therapy is a cornerstone in OA treatment, and systematic reviews of the available data from randomized trials suggest the pain-relieving effect immediately after the treatment being larger in patients with knee OA, effect size -0.49 [-0.59, -0.39] 4, compared to hip OA, effect size -0.38 [0.55, -0.20] 5. It is difficult to determine if the difference in pain relieving effect reported in systematic reviews is due to different response to exercise therapy in patients with knee and hip OA, or if it is due to program variables. Knowledge on the comparable treatment effects when knee and hip patients have participated in the same program and exercised together may help guide prioritization in the health care system
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