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Objective  To determine if people with incident accelerated knee osteoarthritis ( AKOA ) were more likely to receive a pharmacological treatment or arthroscopic knee surgery than those with typical knee osteoarthritis ( KOA ) or no  KOA .    Methods  We conducted a nested cohort study using data from baseline and the first 8 years of the Osteoarthritis Initiative. Eligible participants had no radiographic  KOA  at baseline (Kellgren‐Lawrence [ KL ] < 2). We classified three groups using  KL  grades: 1)  AKOA : knee progressed to advanced‐stage  KOA  ( KL  3/4) in 4 years or less, 2) typical  KOA : knee increased in  KL  grade by 8 years (excluding  AKOA ), and 3) No  KOA : no change in  KL  grade by 8 years. The outcome was self‐reported arthroscopic knee surgery or a pharmacological treatment option: nonsteroidal anti‐inflammatory drugs ( NSAID s), hyaluronic acid injections, intra‐articular corticosteroid injections, or prescription analgesics. Between‐group differences in therapeutic use were evaluated with Chi‐square tests.    Results  Adults who developed  AKOA  (n = 92) were more likely to report arthroscopic knee surgery ( AKOA : 32%,  KOA  [n = 380]: 8%, no  KOA  [n = 875]: 3%;  P  < 0.001), hyaluronic acid injections ( AKOA : 10%,  KOA : 4%, no  KOA : 1%;  P  < 0.001), intra‐articular corticosteroid injections ( AKOA : 30%,  KOA : 7%, no  KOA : 4%;  P  < 0.001), and  NSAID  use (over the counter:  AKOA : 65%,  KOA : 48%, and no  KOA : 46%;  P  = 0.003; prescription:  AKOA : 61%,  KOA : 43%, no  KOA : 41%;  P  = 0.002).    Conclusion  Adults with  AKOA  are more likely to receive pharmacological treatment or arthroscopic knee surgery than their peers. Adults with  AKOA  are an important patient population that is understudied in clinical research despite their use of greater health care resources.

acr open rheumatology

Adults With Incident Accelerated Knee Osteoarthritis Are More Likely to Use Pharmacological Treatment Options and Receive Arthroscopic Knee Surgery: Data From the Osteoarthritis Initiative