Patients with knee osteoarthritis can improve
with non-surgical treatment regardless of imaging tests results

Scans may be used to determine which type of treatment is needed

Knee osteoarthritis (OA) is a condition in which protective cartilage in the knee gradually wears away over time, which leads to pain and disability. It is particularly common in the elderly, and its prevalence is expected to grow as the population ages. Though symptoms are usually helpful enough to show how severe knee OA is, some patients are told to have radiographic imaging tests like magnetic resonance imaging (MRI) or computed tomography (CT) scans to determine this. It's believed that these tests can help predict how patients with knee OA will respond to non-surgical treatment, but there is conflicting data on this topic. Therefore, a study was conducted in which patients with knee OA were evaluated to see if results from these scans influenced how well they responded to treatment.

Large group of patients with knee OA given questionnaire

Patients with knee OA that received non-surgical treatment were asked to participate, and a total of 1,414 responded and completed the study. Each of these participants was given a questionnaire with questions regarding their pain, other symptoms, treatment type, results from imaging tests and opinions about their knees. Questionnaire responses from this large sample of patients were then analyzed to determine the role of imaging test results.

No association found between imaging results and improvements in pain

Results from questionnaires showed that there was no association between the severity of radiographic imaging tests and improvements in pain after non-surgical treatment. This was found to also be the case after adjusting for certain patient factors and the type of treatment received, which may have influenced results. This means that patients were just as likely to improve with non-surgical treatment regardless of how severe their knee OA was, according to imaging tests. For this reason, surgeons who deal with these types of patients can confidently refer them to non-surgical treatment even if they have severe knee OA or are overweight. This non-surgical treatment should follow clinical guidelines, which recommend physical therapy including exercise and patient education as the best strategy for these patients.

-Summarized by Greg Gargiulo

-As reported in the March '15 issue of Acta Orthopaedica