RISK FACTORS
MALALIGNMENT 41,44
GENDER 5,9
GENETICS 2,48
KNEE OVERLOAD 5,7,45,49
OBESITY 5,9
AGING 5,9
PREVIOUS KNEE INJURY 43,47
MUSCLE WEAKNESS 34,40
Fig. 1: Risk factors for knee OA
TREATMENT GAP
• The treatment gap is the time from unsuccessful exhaustion of conservative treatment to surgical intervention. During this treatment gap chronic pain and disability are endured by the patients and substantial economic resources are depleted 27,28 . • London et al. calculated that approximately 20% of American patients with symptomatic knee OA linger in this treatment gap for 10 years. For younger patients, this can extend to 20 years 28 , and the clinical scenario can be challenging because they often seek to remain involved in sporting activities. 21 • The off-loading knee brace is a cost-effective method as a bridging therapy and its long-term use can delay and reduce surgical intervention 26,29 . • A study by Lee et al. (2017) showed that patients who wore an off-loading knee brace for 2 years or more did not require surgery at 8 years follow-up 26 .
18m
16m
20% Treatment Gap
Difficulty with Ambulation
14m
12m
10m
8m 6m
4m
2m
Normal Ambulation
0
Knee Arthroplasties & HTOs
13.9m 3.6m 0.5m
Treatment Gap
Conservative Treatments
Fig. 2: The Treatment Gap 28
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