Abstract
Objectives
We are certainly far from a consensus on the best form of knee osteoarthritis treatment or on an effective treatment recommendation. Moreover, indication for total knee arthroplasty still subjective and depends on several aspects such as physician’s experience, patient’s perception and also the treatment carried out so far. There is a non-negligible number of patients who end up undergoing arthroplasty when they could improve with conservative treatment if they had access to adequate treatment. The objective of this study is to evaluate the impact of an individualized conservative treatment in part of OA patients referred for surgical treatment, awaiting total knee replacement.
Methods
We enrolled 77 patients referred to the knee surgery outpatient clinic of a University Hospital, with indication of total knee arthroplasty. They were divided into two groups: treatment group received target-based approach care and the waiting group received standard treatment. All patients underwent radiographic analysis according to Kellgren & Lawrence, functional evaluation with application of the VAS scale, WOMAC questionnaire, SF-36 questionnaire, 6MWT and muscular strength evaluation.
Results
The treatment group presented lower perception regarding pain intensity (P = 0.017). As well as improvement in the quality of life compared to the waiting group, an increase in SF-36 scores was observed in the SF-36 AF (P = 0.49) and SF-36 AS (P = 0.013), SF-36 EGS (P = 0.003) and SF-36 V (P = 0.042). In the treatment group there was improvement in the functional capacity of the lower limb, as demonstrated by reduction of knee extensor torque deficit (P <0.001) and increase in distance in the 6MWT (P <0.001).
Conclusion
Target-besed approach conservative treatment improved symptoms and quality of life in OA patients with an indication for total knee replacement.