Questionnaire on willingness and preference for biological treatment of knee osteoarthritis: a single-center cross-sectional survey.

objectiveUnderstand the willingness and preference of patients with knee osteoarthritis for biological treatment, and the current status of knee osteoarthritis treatment.

methodsKOA patients with grades 1-4 Kellgren-Ray (K-L) in the knee of our imaging department from November 1, 2022, solstice May 1, 2023, were included in this single-center cross-sectional survey. The questionnaire was designed through the online questionnaire platform, and 502 questionnaires were completed, of which 393 were eligible for this study.

results(1) Basic information: 66.67% (262/393), female, male 33.33% (131/393), male: 1:2; patients aged 45-69 years 89.06% (350/393); 28.50% (112/393); first degree relatives' osteoarthritis 6.87% (27/393); hyperlipidemia 10.94% (43/393); hypertension 30.79% (121/393); diabetes 9.16% (36/393). (2) Disease assessment: the patients had a significant negative relationship between Lysholm score and WOMAC score, with a correlation coefficient of - 0.632, p < 0.01. Using the Kruskal-Wallis test statistic, the Lysholm score showed different K-L grade samples for the WOMAC score (p < 0.01). (3) Classical treatment: 84.99% of the subjects had no attempted basic treatment for osteoarthritis. 94.40% had not tried 4 exercise therapies for osteoarthritis. 96.95% had not attempted physical therapy for osteoarthritis. 98.73% did not try exercise aids for osteoarthritis. 67.94% had not tried TCM treatment for osteoarthritis, accounting for 18.58%, two accounted for 10.69%, three accounted for 2.04%, and four accounted for 0.76%. 77.35% did not try nonsteroidal anti-inflammatory drugs for osteoarthritis, 16.03%, 6.36%, and six 0.25%. 87.02% had not tried non-class NSAIDs analgesic drugs for osteoarthritis, using weak opioid analgesics 10.69% and strong opioid analgesics 2.29%. 95.93% denied previous use of glucocorticoids for osteoarthritis, 16 but not consistently. 85.75% had not tried using slow-acting drugs (SYSADOAs) to relieve OA symptoms, 11.45% and 2.80%, respectively. 99.24% denied taking antidepressant anxiety medication for osteoarthritis. 92.37% denied attempted knee cavity injection (sodium hyaluronate, glucocorticoids), 25 had sodium hyaluronate injection in the joint cavity, 6.36%, and 5 had glucocorticoid injection, 1.27%. (4) Biological therapy situation: 96.44% did not know the biological therapy of the knee cavity for osteoarthritis. 96.69% were not recommended for knee cavity biological treatment, 13 people were recommended, accounting for 3.31%, of which 11 were recommended by doctors, accounting for 84.62% (11/13), and relatives recommended for 15.38% (11/13). In the Likert5 scoring method of joint cavity biological treatment, 10 people in this study were very reluctant, accounting for 2.54%; 37 preferred unwilling, accounting for 9.41%; 264, average, accounting for 67.18%; 40 preferred, accounting for 10.18%; 42, very willing, accounting for 10.69%. The stepwise regression analysis of the factors affecting the willingness to treat joint cavity biotherapy, the previous treatment with sodium hyaluronate or corticosteroid knee cavity injection, WOMAC score will have a significant positive effect on the willingness score of joint cavity biotherapy. In addition, age had a significant negative effect on the willingness to treat the joint cavity. (5) The analysis was performed by MaxDiff: efficacy, course of treatment, side effects, medical expenses, and administration pathways (oral, external use, and intra-articular injection), subject preference for choosing a joint cavity biotherapy. The preferred shares are, respectively. Efficacy > side effect > medical expenses > course of treatment > administration pathways, 69.42% > 15.85% > 6.39% > 4.93% > 3.41%.

conclusionIn this study, KOA subjects, most had not received osteoarthritis-related standard treatment, and the proportion of TCM treatment was relatively high. The low awareness rate of knee biological therapy, the joint cavity injection treatment, high WOMAC score, and age have an impact on the treatment intention of biologics. Efficacy is the most important factor in patient preference for KOA treatment. Key Points • The low awareness rate of knee biological therapy, the joint cavity injection treatment, high WOMAC score, and age have an impact on the treatment intention of biologics. • Efficacy is the most important factor in patient preference for KOA treatment.