If a patient is deemed inappropriate for a TKR, do they receive appropriate care to manage their knee OA?
According to this study (PMID: 36475282) of 250 patients, they do not. Reasons for denial included lack of symptom severity (56%), recommended non-op treatment first (20%), high surgical risk due to co-morbidities (14%), the patient declined surgery (6%), and other reasons (4%). After 6 years, 34% received a TKR.
The number may have been that high because only 19% followed all of the guideline-consistent non-op treatments. Almost all (99%) did follow at least one recommendation, however, only 37% attempted to manage or reduce weight, only half met aerobic physical activity guidelines, and only 12% performed strength training.
Non-op care is only a viable strategy if the patients complete the necessary plan of care. How can we improve non-op treatment adherence?