ArticleBMJ open2015
Variation in use of non-surgical treatments among osteoarthritis patients in orthopaedic practice in the Netherlands.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Utilisation of outpatient physiotherapy in patients following total knee arthroplasty - a systematic review.BMC musculoskeletal disorders · 2021Pooled it
- Pooled it
- Which patient-specific and surgical characteristics influence postoperative pain after THA in a fast-track setting?BMC musculoskeletal disorders · 2017Trial
- German rehabilitation after total hip or knee arthroplasty through Dutch eyes: a qualitative focus group pilot study.BMC research notes · 2026Article
- Measurement of expectations regarding exercise therapy of patients with hip and knee osteoarthritis: A scoping review.Osteoarthritis and cartilage open · 2025Article
- Article
- Characteristics of GLA:D® Canada Hip and Knee Osteoarthritis patients at the Canadian Memorial Chiropractic College: a retrospective analysis of registry-based cohort data.The Journal of the Canadian Chiropractic Association · 2025Article
- Osteoarthritis.Nature reviews. Disease primers · 2025Review
- Osteoarthritis: multitissue pathology, molecular mechanisms, clinical management, and emerging precision and regenerative therapies.Frontiers in pharmacology · 2025Review
- A mixed-methods study of patient and healthcare professional perceptions of care pathways for knee osteoarthritis.BMC primary care · 2024Article
- Usage of guideline-adherent core treatments for knee osteoarthritis before and after consulting an orthopaedic surgeon: A prospective cohort study.Osteoarthritis and cartilage open · 2023Article
- Article
- Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study.BMC health services research · 2023Article
- Article
- The GLA:D® Canada program for knee and hip osteoarthritis: A comprehensive profile of program participants from 2017 to 2022.PloS one · 2023Article
- Use of Physiotherapy Prior to Total Knee Arthroplasty-Results of the Prospective FInGK Study.Healthcare (Basel, Switzerland) · 2022Article
- Non-surgical treatment before hip and knee arthroplasty remains underutilized with low satisfaction regarding performance of work, sports, and leisure activities.Acta orthopaedica · 2020Article
- Patients with osteoarthritis are least likely to receive lifestyle advice compared with patients with diabetes and hypertension: A national health survey study from Denmark.Osteoarthritis and cartilage open · 2020Article
- On the waiting list for joint replacement for knee osteoarthritis: Are first-line treatment recommendations implemented?Osteoarthritis and cartilage open · 2020Article
- Regional variation in hip and knee arthroplasty rates in Switzerland: A population-based small area analysis.PloS one · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesNational and international evidence-based guidelines for hip and knee osteoarthritis (OA) recommend to start with non-surgical treatments, followed by surgical intervention if a patient does not respond sufficiently to non-surgical treatments, but there are indications that these are not optimally used. The aim of this study was to assess the extent to which all recommended non-surgical treatments were used by patients with hip or knee OA who receive(d) a total hip or knee replacement, as reported by patients and orthopaedic surgeons.
settingWe performed two cross-sectional internet-based surveys among patients and orthopaedic surgeons throughout the Netherlands.
participants195 OA patients either have undergone total knee arthroplasty or total hip arthroplasty no longer than 12 months ago or being on the waiting list for surgery with a confirmed date within 3 months and 482 orthopaedic surgeons were invited to participate. PRIMARY AND SECONDARY OUTCOME MEASURES: The use of recommended non-surgical treatments including education about OA/treatment options, lifestyle advice, dietary therapy, physical therapy, acetaminophen, NSAIDs and glucocorticoid injections.
results174 OA patients (93%) and 172 orthopaedic surgeons (36%) completed the surveys. Most recommended non-surgical treatments were given to the majority of patients (eg, 80% education about OA, 73% physical therapy, 72% acetaminophen, 80% NSAIDs). However, only 6% of patients and 10% of orthopaedic surgeons reported using a combination of all recommended treatments. Dietary therapy was used least frequently. Only 11% of overweight and 30% of obese participants reported having received dietary therapy and 28% of orthopaedic surgeons reported to prescribe dietary therapy to overweight patients.
conclusionsWhile most recommended non-surgical treatments were used frequently as single therapy, the combination is used in only a small percentage of OA patients. Especially, use of dietary therapy may be improved to help patients manage their symptoms, and potentially delay the need for joint arthroplasty.
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