Title: Patient Knowledge of Conservative Management of Symptomatic Knee Osteoarthritis at Orthopedic Clinic, in SFHP, Riyadh (A Primary Health Care Prospective)

Authors: Anfal Mohammad Aljohani, Medhat A Ghoraba

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.106

Abstract

Background: Knee osteoarthritis is a joint disease that is either symptomatic or asymptomatic. Changes in structures in and around knee joint occurs in this condition. This disease is more dominant in females than in males, the prevalence also is increasing with increased age and presence of obesity. Knee osteoarthritis is managed by non- operative treatment options such as exercise and analgesics in primary care.

Aim: To assess patient knowledge about non operative treatment of symptomatic knee osteoarthritis provided in family medicine department.

Method: This study is cross sectional descriptive study, it was conducted between the periods from 1st May 2017 to 1stDecember 2017 on symptomatic knee OA patients who were visiting the orthopedic clinic at family medicine department in Security Forces Hospital. The study was performed using questionnaire. All Statistical analysis was perform using SAS version 9.2 (SAS Institute, Inc, Cary, NC).

Results: 43.6% of patients knew about conservative management for knee OA, weight reduction was the most common strategy known by patients (95.1%), followed by physiotherapy (77%), and then pain killer (45.9%). 94.3% of patients used pain killer, 51.4% used weight reduction, 75.7% used physiotherapy and 25% used intra-articular injections. 

Conclusion: There was low knowledge of patients about knee OA conservative management, several demographics and co-morbidities were associated with the level of knowledge. Patients had negative attitude to family physicians regarding their treatment.

Keywords: Knee OA management, Knowledge, Knee OA patients, Family physicians.

References

  1. Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013; 105: 185-199.
  2. Hafez AR, Alenazi AM, Kachanathu SJ, Alroumi AM, Mohamed ES. Knee Osteoarthritis: A Review of Literature. Phys Med Rehabil Int. 2014;1(5): 8.
  3. KELLGREN JH, LAWRENCE JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957; 16: 494-502.
  4. de Miguel Mendieta E, Cobo Ibáñez T, Usón Jaeger J, Bonilla Hernán G, Martín Mola E . Clinical and ultrasonographic findings related to knee pain in osteoarthritis. Osteoarthritis Cartilage. 2006; 14: 540-544.
  5. Kristoffersen H, Torp-Pedersen S, Terslev L, Qvistgaard E, Holm CC, Ellegaard K, et al. Indications of inflammation visualized by ultrasound in osteoarthritis of the knee. Acta Radiol. 2006; 47: 281-286.
  6. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987; 30: 914-918.
  7. Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G . A meta-analysis of sex differences prevalence, incidenceand severity of osteoarthritis. Osteoarthritis Cartilage. 2005; 13: 769-781.
  8. Nuki G, Salter D. The impact of mechanical stress on the pathophysiology of osteoarthritis. In :Sharma L & Berenbaum F (eds). Osteoarthritis. Philadelphia: Mosby;2007: pp.33-52.
  9. Neil A Segal, James Torner, David Felson, Jingbo Niu, Leena Sharma, Cora E. Lewis, et al.: The Effect of Thigh Strength on Incident Radiographic and Symptomatic Knee Osteoarthritis in the Multicenter Osteoarthritis (MOST) Study, Arthritis Rheum. 2009 September 15; 61: 1210–1217.
  10. Lane NE, Thompson JM. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. Am J Med. 1997; 103: 25S-30S.
  11. Foster NE, Thomas E, Barlas P, Hill JC, Young J, Mason E, et al . Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial. BMJ. 2007; 335: 436.
  12. Melanie A Holden, Elaine E Nicholls, Elaine M Hay, Nadine E Foster: Physical Therapists’ Use of Therapeutic Exercise for Patients With Clinical Knee Osteoarthritis in the United Kingdom: In Line With Current Recommendations?, Phys Ther. 2008 October; 88(10): 1109–1121.
  13. Losina E, Weinstein AM, Reichmann WM, Burbine SA, Solomon DH, Daigle ME, et al. Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US. Arthritis Care Res (Hoboken). 2013; 65: 703-711.
  14. Hochberg M.C., Altman R.D., April K.D., Benkhalt M., Guyatt G., McGowan J., Towheed T., Welch V., Wells G. & Tugwell P. American College of Rheumatology 2012 recommendations for the use of no pharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip and knee. Arthritis Care & Research;2012: 64(4), 465–474.
  15. Current Care Guidelines (2014) Polvi- ja lonkkanivelrikko (Knee and hip osteoarthritis). Retrieved from http://www.kaypahoito.fi/ web/kh/suositukset/suositus;jsessionid=301D0B5375B902FA3C82 BD6D475A79C7?id=hoi50054#NaN on 28 January 2015.
  16. Mas X, Barraquer ME. Gonalgia. Actualización en Medicina de Familia 3[5]. 2013. p. 249–58.
  17. Claudia Lckinger, MBBCh (wits), FCP (SA), Cer Rheum, Mohammed Tikly, MBBCh (wits), et al . Current approach to diagnosis and management of osteoarthritis (July 2010). Division of Rheumatology, Chris Hani , Baragwanath hospital and university of the Witwatersrand, Johannesburg 52: 382-390.
  18. Oosterveld FG, Rasker JJ . Treating arthritis with locally applied heat or cold. Semin Arthritis Rheum. 1994; 24: 82-90.
  19. Carvalho NA, Bittar ST, Pinto FR, Ferreira M, Sitta RR . Manual for guided home exercises for osteoarthritis of the knee. Clinics (Sao Paulo). 2010; 65: 775-780.
  20. Chiranthanut N, Hanprasertpong N, Teekachunhatean S . Thai massage, and Thai herbal compress versus oral ibuprofen in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial. Biomed Res Int. 2014; 2014: 490512.
  21. March L., Amatya B., Osborne R.H. & Brand C. Developing a minimum standard of care for treating people with osteoarthritis of the hip and knee. Best Practice and Research. Clinical Rheumatology;2010: 24(1), 121–145.
  22. Alami S, Boutron I, Desjeux D, Hirschhorn M, Meric G, Rannou F, Poiraudeau S. Patients' and practitioners' views of knee osteoarthritis and its management: a qualitative interview study. PLoS One. 2011 May 5;6(5):e19634.
  23. Walker J. Effective management strategies for osteoarthritis. British Journal of Nursing; 2011:20(2), 81–85.
  24. De Haes H. & Bensing J. Endpoints in medical communication research, proposing a framework of functions and outcomes. Patient Education and Counseling;2009: 74(3), 287–294.
  25. Reid DA, Potts G, Burnett M, Konings B. Physiotherapy management of knee and hip osteoarthritis: a survey of patient and medical practitioners’ expectations, experiences and perceptions of effectiveness of treatment. Journal of Physiotherapy. 2014;42(2):118-25.
  26. Fransen M, McConnell S, Bell M. Exercise for osteoarthritis of the hip or knee. Cochrane Database Syst Rev. 2003; : CD004286.

Corresponding Author

Anfal Mohammad Aljohani

Family Medicine Resident