HealthDay News — Nonsurgical osteoarthritis care is associated with lower rates of total knee arthroplasty (TKA) among elderly Americans with knee osteoarthritis, according to a study published online June 8 in Arthritis & Rheumatology.
Michael M. Ward, MD, from the US National Institute of Arthritis and Musculoskeletal and Skin Diseases in Bethesda, Maryland, assessed differences in health care utilization among patients with knee osteoarthritis based on geographic differences in rates of TKA. The analysis included 988,570 U.S. Medicare beneficiaries (2005 to 2010).
Ward found that one-third of the beneficiaries had TKA during a median 5.6 years of follow-up. Use of physical therapy, specialist care, and intra-articular treatments were associated with a lower risk for arthroplasty, while higher rates of visits for knee complaints were associated with increased risks for arthroplasty. The frequency of TKA varied from 26.4% in the lowest-quintile region to 42.1% in the highest quintile. There was an inverse relationship observed between rates of physician visits, physical therapy, specialist care, and use of intra-articular injections and arthroplasty quintile. In the lowest arthroplasty quintile region, physical therapy was used by 32.5% of beneficiaries vs 23.6% in the highest-quintile region.
“In addition to its low use overall, conservative care was less commonly used in regions of the country with high rates of knee replacements, suggesting that surgery may more often be substituted for conservative care in these regions,” Ward said in a statement.