Nonoperative treatment improves XXXX irrespective of radiographic severity.

@entity1 @entity626 @entity571 @entity158 @entity71635
UNASSIGNED: Background and purpose - The discrepancy between symptoms and radiographic severity of @entity626 ( @entity571 ) is well described. However, little is known about whether radiographic severity is predictive of the clinical result of nonoperative treatment. We investigated whether radiographic severity and treatment type were associated with improvements in @entity158 after nonoperative treatment of @entity1 with knee @entity571 . @entity1 and methods - A 5-year consecutive series of @entity1 deemed not eligible for total knee arthroplasty (TKA) by an experienced orthopedic surgeon was contacted 1-5 years later. Radiographic severity, age, sex, and BMI were registered at the consultation. At follow-up, @entity1 were asked to answer a questionnaire on type of treatment and improvements in @entity158 after treatment. Results - Of 1,848 @entity1 who were not eligible for @entity71635 ,414 (77%) completed the follow-up questionnaire (mean age 66 (24-96) years; 55% @entity1 ). Radiographic severity was not associated with improvements in @entity158 even after adjusting for treatment type, age, sex, and BMI (p > 0.1). The odds ratio of improvement was higher by a factor of 2 in @entity1 who received physiotherapy or multimodal treatment than in @entity1 who did not. Interpretation - Radiographic severity was not associated with improvements in @entity158 after nonoperative treatment. @entity1 who are not eligible for TKA can confidently be referred to nonoperative treatment even if they have severe radiographic @entity571 . The treatment should preferably be multimodal, including physiotherapy, as recommended in Danish and international clinical guidelines.
