{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:57Z","timestamp":1787017077539,"version":"build-2736575974"},"reference-count":36,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T00:00:00Z","timestamp":1695340800000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007949","name":"Reumatikerf\u00f6rbundet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007857","name":"Stiftelsen Konung Gustaf V:s 80-\u00e5rsfond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007857","id-type":"DOI","asserted-by":"publisher"}]},{"name":"\u00d6sterlund Foundation"},{"DOI":"10.13039\/501100006075","name":"Greta och Johan Kocks stiftelser","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006738","name":"Medicinska Fakulteten, Lunds Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006738","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Governmental Funding of Clinical Research within National Health Service"},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,8,22]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate temporal trends in primary care visits, physiotherapy visits, dispensed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in knee osteoarthritis (OA) patients who have and have not undergone knee replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed 5665 OA patients from the Sk\u00e5ne Healthcare Register, Sweden, who underwent knee replacement between 2015 and 2019. Controls were OA patients without knee replacement, matched 1:1 by sex, age, time and healthcare level of initial OA diagnosis, and assigned a pseudo-index date corresponding to their case\u2019s knee replacement date. Annual prevalence and prevalence ratio of primary care and physiotherapy visits, dispensed NSAIDs and opioids (all for any cause) in the 10 years before knee replacement were estimated using Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The annual prevalence of all-cause primary care visits, physiotherapy visits and opioid use was similar between cases and controls until 3 years before the index date when it started to increase among the cases. The year before the index date, the prevalence ratio (cases vs controls) for physiotherapy use was 1.8 (95% CI 1.7, 1.8), while for opioid use 1.6 (1.5, 1.7). NSAID use was consistently higher among cases, even 10 years before the index date when the prevalence ratio versus controls was 1.3 (1.2, 1.3), increasing to 1.8 (1.7, 1.9) in the year preceding the index date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Management of OA patients who have and have not undergone knee replacement appears largely similar except for higher use of NSAIDs in knee replacement cases. Symptomatic treatments start to increase a few years before the surgery in knee replacement cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003422","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T11:15:35Z","timestamp":1695381335000},"page":"e003422","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis: a 10-year population-based case\u2013control study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0319-458X","authenticated-orcid":false,"given":"Andrea","family":"Dell'Isola","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Hellberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Turkiewicz","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Appleyard","sequence":"additional","affiliation":[{"name":"Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8449-7725","authenticated-orcid":false,"given":"Dahai","family":"Yu","sequence":"additional","affiliation":[{"name":"Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK"},{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Newcastle, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraint","family":"Thomas","sequence":"additional","affiliation":[{"name":"Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Peat","sequence":"additional","affiliation":[{"name":"Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Englund","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,9,22]]},"reference":[{"key":"2025090312061272000_9.3.e003422.1","doi-asserted-by":"crossref","first-page":"100587","DOI":"10.1016\/j.eclinm.2020.100587","article-title":"Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies","volume":"29\u201330","author":"Cui","year":"2020","journal-title":"EClinicalMedicine"},{"key":"2025090312061272000_9.3.e003422.2","unstructured":"Socialstyrelsen . Nationella Riktlinjer F\u00f6r R\u00f6relseorganens Sjukdomar. Reumatoid Artrit, axial Spondylartrit, Psoriasisartrit, Artros och Osteoporos. Socialstyrelsen Stockholm 2021."},{"key":"2025090312061272000_9.3.e003422.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2019.06.011"},{"key":"2025090312061272000_9.3.e003422.4","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1136\/annrheumdis-2013-204801","article-title":"EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis","volume":"73","author":"Vliet Vlieland","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"2025090312061272000_9.3.e003422.5","unstructured":"National Institute for Health and Care Excellence (NICE) . Osteoarthritis in over 16S: diagnosis and management. 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Waiting time in healthcare 2023, Available: https:\/\/skr.se\/vantetiderivarden\/vantetidsstatistik\/tillganglighetovertid.44513.html"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003422","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:06:23Z","timestamp":1756926383000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003422"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,9,22]]},"published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1136\/rmdopen-2023-003422"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003422","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}