Abstract
Background Knee osteoarthritis (KOA) is a high incidence chronic joint disease that seriously affects patients' quality of life, and current treatment methods have limited efficacy. Self-management may be an effective strategy for KOA, and clinicians have been showing increased interest recently. However, the effectiveness of self-management for KOA remains controversial. Purpose This study aims to systematically evaluate the effectiveness of self-management for KOA. Methods We screened articles published in MEDLINE, Cochrane Library, EMBASE, and Web of Science until September 17, 2021. The main outcomes included pain, knee function, stiffness, WOMAC (total), physical function, arthritis self-efficacy (ASE-pain), arthritis self-efficacy (ASE-other symptoms), mental health, and quality of life. Results Thirteen randomized controlled trials (RCTs) were finally included (n = 1610). Meta-analysis showed differences in pain, knee function, stiffness, ASE-pain, ASE-other symptoms, mental health, and quality of life between the self-management and control groups. Of the nine outcomes evaluated, four were highly heterogeneous, and the quality of evidence ranged from very low to moderate. Conclusion The meta-analysis results showed that self-management might help improve the pain, knee function, stiffness, ASE, mental health, and quality of life in patients with KOA. However, it has no significant effect on WOMAC (total) and physical function. Considering that this study has some limitations, we cannot draw clear conclusions based on the results of this study. Nevertheless, we offer much needed insight and encourage more rigorously designed and implemented RCTs in the future to substantiate our conclusions.
Highlights
Osteoarthritis is the most common chronic joint disease and one of the main causes of pain and disability, while knee osteoarthritis (KOA) is the most common joint disease [1, 2]
We searched MEDLINE, EMBASE, Cochrane library, and Web of Science databases until September 17, 2021. e following search terms were used: “osteoarthritis, knee,” Knee osteoarthritis,” Knee Osteoarthritides,” Osteoarthritis of Knee,” Osteoarthritis of the knee,” Self-Management,”“ Self-Management,” Management, Self,” Randomized Controlled Trial,” Clinical Trial,” random allocation.” e specific search strategy is shown in the Supplementary Appendix. e first researcher searched the MEDLINE database, the second researcher searched EMBASE and Cochrane Library databases, the third researcher searched the Web of Science database, and the fourth researcher repeated the search process and search results of all databases
We initially searched 6134 related studies from four electronic databases (MEDLINE, Embase, Cochrane Library, and Web of Science) and imported them into NoteExpress 3.3.0 software to screen for duplicate literature, titles, and abstracts. 1228 repeated studies were excluded, and 4830 studies were excluded through reading titles and abstracts. 76 studies were downloaded in full to further determine whether they met the inclusion criteria
Summary
Osteoarthritis is the most common chronic joint disease and one of the main causes of pain and disability, while knee osteoarthritis (KOA) is the most common joint disease [1, 2]. Arthroplasty is a management strategy for advanced KOA, but it has many potential shortcomings and might not be the best choice for many patients It is often only considered when other treatment methods are ineffective [13–15], and physicians agree that total knee arthroplasty should not be carried out too early [16]. Meta-analysis showed differences in pain, knee function, stiffness, ASE-pain, ASE-other symptoms, mental health, and quality of life between the self-management and control groups. E meta-analysis results showed that self-management might help improve the pain, knee function, stiffness, ASE, mental health, and quality of life in patients with KOA. It has no significant effect on WOMAC (total) and physical function. We offer much needed insight and encourage more rigorously designed and implemented RCTs in the future to substantiate our conclusions
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