The Clinical Course of Hip and Knee Osteoarthritis in Adults Attending Two Hospital Outpatient Physiotherapy Clinics in NSW: An Evaluation of the Osteoarthritis Chronic Care Program (OACCP)

Abstract

BACKGROUND: Osteoarthritis (OA) affects over 700,000 individuals in NSW, with projections estimating an increase to 1 million by 2030. This has led to a significant rise in joint replacement surgeries and associated healthcare costs. Despite guidelines recommending non-surgical care as first line treatment, many patients remain on surgical waiting lists without accessing these treatments. AIM: The aims of this study were to describe the characteristics and clinical outcomes of people with hip and knee OA attending two Sydney Local Health District (SLHD) Osteoarthritis Chronic Care Program (OACCP) clinics, and to identify whether baseline measures are associated with achieving Minimal Clinically Important (MCI) difference in outcomes. METHODS: This retrospective study (n = 1402) evaluated the OACCP's implementation within two SLHD hospitals between Oct 2018 and Sept 2023, describing patient characteristics, patient reported outcomes, physical performance measures, and allied health access. Changes in clinical outcomes in the short-term (3 months) and long-term (12 months) assessment as well as associations of patient's baseline measures with MCI improvements in clinical outcomes were analysed. RESULTS: Most self-reported outcomes and physical performance measures improved at both 3 and 12 months. 38.6% of patients reached the MCI threshold for KOOS total score at 3 months, which rose to 52.1% at 12 months. None of the baseline characteristics predicted outcomes. CONCLUSION: Following multidisciplinary non-surgical care, people with hip and/or knee OA experience improved quality of life and function that is sustained for up to 12 months. However, analysis was limited by low long-term follow-up rates and no control group.