Rapid Onset Knee Osteoarthritis May be Overtreated

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Adults with rapid onset knee osteoarthritis that occurs and progressess within as little as four years, are more likely to receive pharmacological treatments or even surgery than those who live with the condition long-term, according to a brief report published last month in ACR Open Rheumatology.

"Those with accelerated knee osteoarthritis utilized treatment options and health care resources far more often than adults who developed typical knee osteoarthritis, likely because they quickly developed advanced‐staged disease," wrote authors who were led by Jeffrey Driban, Ph.D., of Tufts Medical Center, Boston.

This was an 8-year long study that included participants with no radiographic knee osteoarthritis at baseline. The study group was broken down into three groups: one with advanced stage knee osteoarthritis that advanced in severity within four years or less; a second group with typical knee osteoarthritis that increased in severity over eight years; and, a third group with no knee osteoarthritis and no change over eight years.

Adults who developed accelerated knee osteoarthritis, also known as rapid onset knee osteoarthritis, were more likely to report having had arthroscopic knee surgery than the knee osteoarthritis group (32 percent vs 8 percent) and have other treatments, such as hyaluronic acid injections (10 and 4 percent, respectively); intra-articular corticosteroid injections (30 and 7 percent, respectively); NSAID use (65 and 48 percent, respectively); and, prescription pain medicatio (61 and  43 percent, respectively).

TAKEAWAYS

• Individuals with rapid onset knee osteoarthritis are more likely to receive a knee replacement than someone who develops knee osteoarthritis that developes over time.

• It may be best to continually evaluate patients for sudden onset knee osteoarthritis after arthroscopic knee surgery.

• In this study, one in three patients with incident knee osteoarthritis used prescription pain killers prior to disease onset, which suggests a neeed to adopt comprehensive treatment strategies that address the underlying risk factors and etiology prior to disease onset.

REFERENCE

Julie E. Davis BS  Matthew S. Harkey PhD, ATC  Shao‐Hsien Liu PhD, et al. "Adults With Incident Accelerated Knee Osteoarthritis Are More Likely to Use Pharmacological Treatment Options and Receive Arthroscopic Knee Surgery: Data From the Osteoarthritis Initiative," ACR Open Rheumatology. First published: 25 July 2019 https://doi.org/10.1002/acr2.11058