An interventional study of Assessment by PT/Orth surgeon in Knee Osteoarthritis and Hip Osteoarthritis, sponsored by Sahlgrenska University Hospital. Recruiting at 2 sites in Sweden. Per ClinicalTrials.gov, last updated 2022-04-13.
Sponsored by Sahlgrenska University Hospital · Not applicable, Interventional, and Health services research
The aim of this project is to compare PT-led triage in secondary care setting for patients with hip or/and knee osteoarthritis (OA) with standard care (i.e. assessment of orthopedic surgeon). Comparison between cost-effectiveness, selection accuracy, patients perceived quality of care, quality of life and physical function will be made.
A further aim is to determine if a digital triage tool can accurately predict when a primary knee or hip referral is deemed for nonsurgical versus surgical intervention by the surgeon following the first consultation.
Osteoarthritis (OA) is a common musculoskeletal disorder and the number of people in need of surgical treatment for hip and knee OA is increasing. The waiting time for consultation with an orthopedic surgeon (OS) is long and the majority of the patient referred for assessment are not appropriate for surgical intervention. To reduce the number of patients seen by an OS and thereby shorten the waiting time, Sahlgrenska University Hospital started a Physiotherapist-led (PT-led) triage project in 2017. With PT-led triage the patients are assessed by a physiotherapist to establish the most appropriate care management; if the patient is appropriate for surgery, should be referred for continued rehabilitation, or referred back to the referring physician. To our knowledge this model of care with PT-led triage in secondary care setting have not been scientifically evaluated in Sweden.
The aim of this project is to compare PT-led triage in a secondary care setting with standard care (i.e. assessment of OS for patients with knee or /and hip OA). A further aim is to determine if a digital triage tool can accurately predict when a primary knee or hip referral is deemed for nonsurgical versus surgical intervention by the surgeon following the first consultation.
Patients referred from primary care to Sahlgrenska University hospital with primary hip and/or knee OA will be included and randomized to consultation with either PT (triage) or OS (standard practice). Data about patient reported health-related quality of life, pain, function, and patients' perception of quality of care will be collected using questionnaires at baseline, 3 and 12 months after the consultation.
Data about waiting time for consultation, proportion of patients appropriate for surgery, further investigations, and data to be able to perform cost analysis will be collected from patients´ journals, the patient administration systems, both locally and via the region Västra Götaland´s database (VEGA).
A digital triage tool will be developed and tested in a cohort of 50 patients before the ortohpedic consultation.
A qualitative approach will be used to further investigate patients experience of a PT-ledtrige
4,398 studies on the registry are indexed under Osteoarthritis; 582 are open to participants now.
This study's planned enrollment of 478 is above the median of 70 across 3,440 interventional studies indexed under Osteoarthritis.
Browse Osteoarthritis studies →Sahlgrenska University Hospital is the lead sponsor of 259 studies on the registry; 68 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Patients are assessed by PT
Other: Assessment by PT/Orth surgeon
The patiens are assessed by a orthopedic surgeon
Other: Assessment by PT/Orth surgeon
Assessment by orthopaedic surgeon or a PT
Short form of the Quality from Patients Perspective (QPP)
A Measure of patients' perception of quality of care regarding four dimensions: caregivers' medical-technical competence; care organizations' physical-technical conditions; degree of identity-orientation in the caregivers' attitudes and actions; and the care organizations' socio-cultural atmosphere
Time frame: Baseline
Heath-related quality of life - EuroQol (EQ5-D)
Measure of health-related quality of life and consists of 5 items. General health is measured using a VAS scale (0 to 100) with 100 being the best possible health state
Time frame: Baseline, 3 and 12 months
Pain Disability index (PDI
A questionnaire where respondents are asked to rate disability on a numeric rating scale ranging from 0 (no disability) to 10 (maximum disability) in seven areas; family and home responsibilities, recreation, social activity, occupation, sexual behavior, self-care, and life-support activity.
Time frame: Baseline, 3 and 12 months
Forgotten Joint Score (FJS)
A questionnaire that was developed to find subtle differences between patients who grade their hip / knee as "very good" and "excellent". The score is graded from 0 to 100, where a high score is better
Time frame: Basline, 3 and 12 months
Oxford Hip/Knee Score (OHS/OHK
A questionnaire consisting of 12 questions that concern areas such as pain and disabilities the patient has experienced during the past four weeks.
Time frame: Basline, 3 and 12 months
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Sahlgrenska University Hospital