McMaster University

McMaster University

Treatment gap in management of early OA: International survey

We is pleased to share with you the most recent publication from the MacOrtho team titled "Orthopedic surgeons feel that there is a treatment gap in management of early OA: international survey" published in Knee Surgery, Sports Traumatology, Arthroscopy.

Find the abstract below and click here to access the full-version of the article.

Li CS, Karlsson J, Winemaker M, Sancheti P, Bhandari M. Orthopedic surgeons feel that there is a treatment gap in management of early OA: international survey. Knee Surg Sports Traumatol Arthrosc. 2013 Jun 18. [Epub ahead of print]


PURPOSE: To understand orthopedic surgeons' views, preferences, and awareness on "treatment gap" and various conservative and surgical treatments for early to mid-stage knee osteoarthritis (OA).

METHODS: A self-administered questionnaire on the treatment of knee OA was developed in collaboration with orthopedic surgeons with extensive research experience and methodological expertise. The survey was distributed electronically to a group of international orthopedic surgeons and surgical trainees. The data were collected, reviewed, and analyzed using descriptive statistics.

RESULTS: One hundred and seventy-three surgeons and surgical trainees completed the survey. The respondents reported that about 58 % of the patients they treat have early to mid-stage knee OA (Kellgren and Lawrence grade I-III). There were significantly higher usage of medications and lower usage of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) (P < 0.05) in developing countries than in developed countries. Four of five surgeons (84 %) perceived a need for better treatments for younger (<60 years old) physically active OA patients in which UKA or TKA is not indicated. Most respondents (80 %) would be willing to adjust age/activity threshold for surgery if a procedure was reversible and recovery was minimal. Two of three surgeons (68.4 %) perceived a treatment gap for early knee OA. However, effective treatments for patients within the treatment gap would have substantial positive social, and economic impacts.

CONCLUSION: The study suggests an ongoing treatment gap for patients with early knee OA and the need for better evidence to guide practice

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