Knee Osteoarthritis Clinical Trial
Official title:
Strategies for Management of Knee Osteoarthritis : Innovation and Medico-economic Study
Osteoarthritis is an evolving joint disease caused by degeneration of bones and cartilage,
with significant personal and social impact. Osteoarthritis of the knee is the most common
type of osteoarthritis, affecting up to 19% of adults (aged 45 and over) according to recent
studies.
The costs associated with the management of osteoarthritis involve not only direct treatment
strategies (clinical evaluations, drugs, prostheses, surgery), but also significant indirect
costs (loss of productivity) The severity of knee osteoarthriris symptoms and the types of
interventions are highly variable. There are surgical and nonsurgical treatment strategies.
The replacement of the knee joint by a total prosthesis is a surgical choice for severe knee
osteoarthritis which currently represents the basic treatment. However, a large proportion of
patients with knee osteoarthritis can not or do not wish to have surgery, either because of
the unavailability of the choice of surgery, or the disability and post-operative pain that
can be caused by surgery.
Since surgery is not always the preferred or available treatment for people with knee
osteoarthritis, it has been shown that acting on modifiable risk factors (severe obesity) can
significantly reduce the pain and disability but it is not always sufficient.
Other effective therapeutic osteoarthritis strategies include biomechanical interventions,
intra-articular injections like corticosteroids ; anti-inflammatory and analgesic drugs,
exercise, patient education and bodybuilding. There is also an innovative strategy that is
under development and consists of the use of nanostructured and functionalized implants for
bone and cartilage regeneration.
The objective of this study is to carry out a medico-economic study centered on knee
osteoarthritis management strategies. At a time when the decisions of management of
pathologies must be based on the efficiency of the possible therapies, and given the high
prevalence of knee osteoarthritis, it appears crucial to carry out this type of study in
order to 'bring elements to public health decision makers. In addition, there is a demand for
medico-economic assessment of osteoarthritis management strategies emerging in the
literature. To carry out this study, we plan to carry out an extensive review of the
literature on relevant non-surgical strategies for patients with moderate and severe knee
osteoarthritis and for whom total knee replacement was feasible. This will aim to extract
data to develop a modeling (Markov models) of knee osteoarthritis management by different
therapeutic strategies. At this stage, the cost and quality of life data for the models will
be searched in order to be linked to the strategy cost within a medico-economic evaluation.
If the literature proves to be insufficient, the use of the data of the University Hospitals
of Strasbourg (retrospective study), the realization of an epidemiological study (prospective
study) will be a possible in order to make the model.
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