Patient Knowledge and Beliefs About Knee Osteoarthritis After Anterior Cruciate Ligament Injury and Reconstruction
Bennell KL, Ginckel AV, Kean CO, Nelligan RK, French SD, Stokes M, Pietrosimone B, Blackburn T, Batt M, Hunter DJ, Spiers L, & Hinman RS. Arthritis Care Res. 2016;68:1180-1185. doi: 10.1002/acr.22794
Take Home Message: Patients who suffered a knee injury have some understanding of their long-term risks. However, there is an astoundingly low number of patients who recall having conversations with health care professionals about the long-term risks after an injury.
We have an earlier post on Sports Med Res about athletic trainers’ knowledge and perceptions of osteoarthritis (OA) after a knee injury. While it is important for sports medicine clinicians to be aware about OA, it is even more important that this information is communicated to patients who suffer a knee injury. Therefore, the authors of this research study wanted to assess the knowledge of patients who had suffered a knee injury about OA, and whether these individuals had conversations with their health professional about their OA risks. The researchers gave a survey to patients who suffered an anterior cruciate ligament (ACL) injury between 1 to 5 years before the survey. Overall, 233 adults completed the survey in Australia and United States. The survey had three parts: 1) personal characteristics, 2) knowledge about OA and OA risk, and 3) health professional advice. Approximately half of the participants were able to correctly identify the definition of OA and believed that they were at a greater risk for developing OA after their knee injury. Most adults (> 73%) agreed that having an ACL injury or meniscal tear increases the risk of knee OA. Over 80% of adults agreed that having knee OA would be a major health concern and within this sample, Australian adults (36%) were more likely than American adults (7%) to strongly agree that having knee OA would be a major health concern. However, about 30% believed that undergoing an ACL reconstruction surgery would decrease their risk of developing OA. Finally, only 27% recalled having a conversation with their health professional about OA risks associated with their knee injury.
This research study is interesting because the knowledge that health care professionals does not appear to be making an impact on patient care. Astoundingly, only 27% of the participants recalled a conversation regarding OA and long-term management after their knee injury. A majority of this advice came from an orthopedic surgeon; however, some advice also came from a physiotherapist or other health care professional. Sports medicine clinicians tend to see these patients regularly, and it is important that we make lasting impressions about long-term joint health. Briefly “mentioning” an increased risk does not make an impact with patients. We need to emphasize the importance of long-term well-being and help to provide strategies for long-term management. Similar to a classroom, we need to make sure that we -- the educated health professionals -- help our patients/students learn the importance of this problem. It is important that a patient understand their risks after a knee injury so that they can make good decisions regarding their long-term joint health. Unfortunately, there are still a good number of patients who believe that getting surgery will decrease their chances of having long-term problems. As clinicians, we should help to educate our patients so that they can understand why they are doing certain things with treatment or rehabilitation. Interesting, the authors also found that Australians were more likely to strongly agree that OA was a major health problem in comparison to the American patients. This study shows us that we need to be more proactive as health care professionals in getting through to our patients about long-term risks of OA following knee injury. This is a widely accepted risk and the importance of long-term management needs to be presented in a way to make a difference to our patients.
Questions for Discussion: What do you think is the best way to make an impression about long-term risks to a patient who has suffered a knee injury? What information do you share with patients after they have suffered a knee injury?
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban