{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:21:30Z","timestamp":1783653690203,"version":"3.55.0"},"reference-count":52,"publisher":"BMJ","issue":"15","funder":[{"name":"NIH-NIAMS","award":["K01AR069720"],"award-info":[{"award-number":["K01AR069720"]}]},{"name":"NIH-NIAMS","award":["K23AR069127"],"award-info":[{"award-number":["K23AR069127"]}]},{"name":"NIH-NIAMS","award":["K24AR070892"],"award-info":[{"award-number":["K24AR070892"]}]},{"name":"NIH-NIAMS","award":["P30 AR0702571"],"award-info":[{"award-number":["P30 AR0702571"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2023,2,15]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We assessed whether late versus early initiation of physical therapy (PT) was related to greater risk of future opioid use in people with knee osteoarthritis (OA) who receive PT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used Commercial and Medicare Advantage claims data from 1999 to 2018 from American adults with incident knee OA referred for PT within 1\u2009year of diagnosis. We categorised people as opioid na\u00efve or opioid experienced based on prior prescriptions. We examined the association of timing of PT initiation with any and chronic opioid use over 1\u2009year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 67\u2009245 individuals with incident knee OA, 35\u2009899 were opioid na\u00efve and 31\u2009346 were opioid experienced. In the opioid na\u00efve group, compared with PT within 1\u2009month, PT 1 to &lt;3, 3 to &lt;6, 6 to &lt;9, 9\u201312 months from diagnosis was associated with adjusted risk ratio (aRR (95% CIs)) for any opioid use of 1.18 (1.10 to 1.28), 1.49 (1.37 to 1.61), 1.73 (1.58 to 1.89) and 1.93 (1.76 to 2.12), respectively; aRRs (95% CIs) for chronic opioid use were 1.25 (1.01 to 1.54), 1.83 (1.48 to 2.26), 2.29 (1.82 to 2.89) and 2.50 (1.96 to 3.19). Results were similar among opioid experienced; aRRs (95% CIs) for any opioid use were 1.19 (1.14 to 1.24), 1.32 (1.26 to 1.37), 1.39 (1.32 to 1.45) and 1.54 (1.46 to 1.61); aRRs (95% CIs) for chronic opioid use were 1.25 (1.17 to1.34), 1.43 (1.33 to 1.54), 1.53 (1.41 to 1.66) and 1.65 (1.51 to 1.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with PT initiation within 1\u2009month, delayed PT initiation was associated with higher risk of opioid use in people with incident knee OA. The longer the delay in PT initiation, the greater was the risk.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2022-106044","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T18:20:12Z","timestamp":1677176412000},"page":"958-964","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Delayed timing of physical therapy initiation increases the risk of future opioid use in individuals with knee osteoarthritis: a real-world cohort study"],"prefix":"10.1136","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1728-484X","authenticated-orcid":false,"given":"Deepak","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Peloquin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Marinko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Camarinos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosaku","family":"Aoyagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T","family":"Felson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Dubreuil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"2024051422494404000_57.15.958.1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2022.101558","article-title":"Long-Term opioid use and mortality in patients with chronic non-cancer pain: ten-year follow-up study in South Korea from 2010 through 2019","volume":"51","author":"Song","year":"2022","journal-title":"EClinicalMedicine"},{"key":"2024051422494404000_57.15.958.2","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.joca.2022.02.621","article-title":"Opioid use prior to total knee replacement: comparative analysis of trends in england and sweden","volume":"30","author":"Yu","year":"2022","journal-title":"Osteoarthritis Cartilage"},{"key":"2024051422494404000_57.15.958.3","doi-asserted-by":"crossref","unstructured":"Rejas-Gutierrez J , Sicras-Mainar A , Darb\u00e0 J . 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