Osteoarthritis of the Knee Clinical Trial
Official title:
Structured Non-operative Treatment of Knee Osteoarthritis - a Randomized Controlled Trial of Pain, Physical Function and Quality of Life With 12months Follow-up
The purpose of this study is to test whether an algorithm for systematic non-surgical
treatment consisting of corrective insoles, neuromuscular training, weight loss, patient
education and pharmacological treatment with paracetamol, non steroidal anti inflammatory
drugs (NSAIDs) and Pantoprazole provides further improvement in pain, function and quality of
life than standard non-surgical treatment (information on the disease and how to treat it) in
patients with knee osteoarthritis.
The H1-hypothesis is that the treatment algorithm results in a greater increase in quality of
life and functional capacity and greater reduction in pain than standard treatment at the
primary endpoint, which is follow-up 12months after the start of the treatment.
See statistical analysis plan available under "Links" for further description of the study.
Knee osteoarthritis (OA) is the degenerative joint disease that most often requires treatment
and at the same time the one associated with the greatest social costs. In addition, the
disease has many personal costs and is greatly contributing to reduced functionality and
autonomy of older adults.
It is recommended both nationally and internationally that the treatment of knee
osteoarthritis should include multiple treatment modalities. Clinical guidelines recommend
that exercise, weight loss and patient education is the first step in treatment and that
insoles and pharmacological treatment can be included as a supplement.
However if the patient is not a candidate for total knee replacement, the patient most often
receives only information on knee osteoarthritis, and on what they can do to treat the
disorder and prevent it from being worse. This postponement of treatment can lead to a
worsening of pain and function and a worse outcome after treatment. Therefore, the current
treatment strategy for the patient group is problematic.
The current practice may be due to the lack of studies with high level of evidence that have
examined the optimal non-operative treatment approach and compared it with the current
standard treatment for this group of patients.
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