Factors associated with patients' willingness to consider joint surgery after completion of a digital osteoarthritis treatment program: A prospective cohort study

Research output: Contribution to journalArticle


OBJECTIVES: To examine patient willingness and possible shift in willingness for surgery and to investigate factors associated with this shift, following participation in the digital non-surgical osteoarthritis (OA) treatment program Joint Academy.

METHODS: 458 individuals (mean age 62±5.6 years, 67% women) with diagnosed hip or knee were evaluated after six weeks in Joint Academy, comprising education and exercise as well as asynchronous chat with a physical therapist. Data describing joint pain, health-related quality of life (EQ-5D-3L), walking difficulties, 30-second Chair Stand Test (30CST) and willingness to consider surgery were collected at baseline and at six weeks.

RESULTS: At follow-up, 31% of those willing to consider surgery at baseline no longer considered surgery. Of those who were unwilling to consider surgery at baseline, 6% re-considered and considered surgery at follow-up. Less pain and a higher EQ-5D-3L index at six weeks were associated with the shift from being willing to unwilling to consider surgery at follow-up (OR=0.67-1.64, p<0.05). Worse pain, a lower EQ-5D-3L index and having walking difficulties at six weeks, and a lower pain and EQ-5D-3L index improvement were associated with the shift from being unwilling to willing to consider surgery at six weeks (OR=0.51-4.30, p<0.005).

CONCLUSIONS: Evidence-based non-surgical OA treatment, at least delivered digitally, may reduce the need for surgery and should therefore be offered as the first-line treatment option to patients with hip and knee OA. Result also supports the notion that such treatment programs have the potential to improve selection of patients for total joint replacement. This article is protected by copyright. All rights reserved.


External organisations
  • Joint Academy Inc
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Orthopedics
Original languageEnglish
Pages (from-to)1194-1201
Number of pages8
JournalArthritis care and research : the official journal of the Arthritis Health Professions Association
Issue number9
Early online date2018 Oct 9
Publication statusPublished - 2019 Sep
Publication categoryResearch