The Management of Knee Osteoarthritis in the Real World: An Italian National Survey
Abstract
1. Introduction
2. Methods
- A first session of Remote Training via a webinar, during which the evidence on the pathophysiology of KOA and the current therapeutic strategies were presented. In this section, it was explained how to use the Activity Book, which is a data collection sheet consisting of 10 questions where clinical features and prescribed therapies are recorded by the physicians in their real clinical practice for each patient affected by KOA. The Activity Book represented the real-world collection tool for the national survey. Each participant was given a maximum of 40 Activity Books, corresponding to 40 patients with KOA.
- A daily practice session, which consisted in the completion by each participant of the Activity Books during the clinical and physical examination of the patients with KOA. The doctors had an Activity Book available for each patient enrolled, where they had to collect different types of data about KOA. First of all, the demographic and anamnestic data and the anthropometric parameters were collected; then, the presence of local signs (edema, thermotact, range of motion) and symptoms (pain, stiffness) of the affected knee was assessed, and also, the knee’s range of motion was measured using a goniometer. Then, in the Activity Book, the physicians were also asked to define the radiological severity of KOA and to check the functional characteristics and the motor abilities in the performance of activities of daily living for each patient with KOA using a dedicated locomotor scale. In the end, in the treatment section of the questionnaire, the physicians had to register all pharmacological therapies (oral and intra-articular) and rehabilitation carried out by the patient up to that point; the participants had to note down the new therapeutic prescription resulting from the structured evaluation according to the standardized questionnaire of the Activity Book for patients with symptomatic KOA.
- A second session of Remote Training through a webinar, in which the overall results were discussed by tutors, including the comparison of the real-world data collected from the practice session with the ESCEO guidelines [11].
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- The demographic and anthropometric characteristics of the examined population: age, weight, height, and Body Mass Index (BMI);
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- The radiological severity of knee osteoarthritis according to the Kellgren–Lawrence (K-L) classification [13];
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- The pain level, measured using the Visual Analogic Scale (VAS);
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- The locomotor skills in walking and the functional abilities of daily living, assessed through the Geriatric Locomotive Function Scale (GLFS);
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- The pharmacological therapy, the rehabilitation treatments, and the intra-articular knee injections before and after the clinical observation.
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Total | Men | Women | |
---|---|---|---|
Sex, number (%) | 2656 | 1155 (45.2%) | 1501 (54.8%) |
Mean age
(mean ± standard deviation) | 67.2 ± 11.7 | 66.8 ± 12.5 | 67.6 ± 11 |
Weight (kg)
(mean ± standard deviation) | 74 ± 11.6 | 79.4 ± 9.7 | 69.9 ± 11.2 |
Mean height (cm)
(mean ± standard deviation) | 167.7 ± 8.3 | 173.7 ± 6.8 | 163.1 ± 6.2 |
Body Mass Index (BMI)
(mean ± standard deviation) | 26.4 ± 3.8 | 26.4 ± 3.1 | 26.4 ± 4.2 |
VAS Mean and SD | GLFS Mean and SD | BMI Mean and SD | |
---|---|---|---|
BMI (range) | |||
18.5–24.9 n: 891 | 5.9 ± 1.5 * | 7.1 ± 4.2 ^ | - |
25–29.9 n: 1135 | 6.5 ± 1.5 * | 8.2 ± 4.3 ^ | - |
30–60 n: 409 | 6.3 ± 1.6 ** | 10.2 ± 4.7 ^ | - |
K-L II n: 882 | 6.2 ± 1.5 ^^ | 7.6 ± 3.9 *** | 26.7 ± 4.2 ^^^ |
K-L III n: 632 | 6.4 ± 1.5 ^^ | 11.3 ± 4.4 *** | 28.7 ± 4.3 ^^^ |
Rehabilitation: YES n: 1389 | 6.1 ± 1.5 | 8.8 ± 4.4 ° | |
Rehabilitation: NO n: 1252 | 6.2 ± 1.6 | 7.6 ±4.3 ° |
Intra-Articular Knee Injection | ||
---|---|---|
Before Observation % | After Observation % | |
BMI (range) | ||
18.5–24.9 n: 891 | 0.3% | 6.8% |
25–29.9 n: 1135 | 0.6% | 6.6% |
30–60 n: 409 | 0.5% | 6.4% |
K-L II n: 882 | 0.2% | 8.6% |
K-L III n: 632 | 0.5% | 8.7% |
GLFS < 6 n: 828 | 0.0% | 6.4% |
GLFS > 6 n: 1797 | 0.5% | 7.9% |
Rehabilitation: YES n: 1389 | 0.5% | 8.9% |
Rehabilitation: NO n: 1252 | 0.3% | 5.6% |
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Codazza, S.; Ferrara, P.E.; Ariani, M.; Ferriero, G.; Ronconi, G., on behalf of “Knee Osteoarthritis: Clinical Practice Evidence” Study Group. The Management of Knee Osteoarthritis in the Real World: An Italian National Survey. J. Clin. Med. 2024, 13, 3704. https://doi.org/10.3390/jcm13133704
Codazza S, Ferrara PE, Ariani M, Ferriero G, Ronconi G on behalf of “Knee Osteoarthritis: Clinical Practice Evidence” Study Group. The Management of Knee Osteoarthritis in the Real World: An Italian National Survey. Journal of Clinical Medicine. 2024; 13(13):3704. https://doi.org/10.3390/jcm13133704
Chicago/Turabian StyleCodazza, Sefora, Paola Emilia Ferrara, Mariantonietta Ariani, Giorgio Ferriero, and Gianpaolo Ronconi on behalf of “Knee Osteoarthritis: Clinical Practice Evidence” Study Group. 2024. "The Management of Knee Osteoarthritis in the Real World: An Italian National Survey" Journal of Clinical Medicine 13, no. 13: 3704. https://doi.org/10.3390/jcm13133704
APA StyleCodazza, S., Ferrara, P. E., Ariani, M., Ferriero, G., & Ronconi, G., on behalf of “Knee Osteoarthritis: Clinical Practice Evidence” Study Group. (2024). The Management of Knee Osteoarthritis in the Real World: An Italian National Survey. Journal of Clinical Medicine, 13(13), 3704. https://doi.org/10.3390/jcm13133704