Development of an intervention to manage knee osteoarthritis risk and symptoms following anterior cruciate ligament injury,Osteoarthritis and Cartilage

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Development of an intervention to manage knee osteoarthritis risk and symptoms following anterior cruciate ligament injury
Osteoarthritis and Cartilage ( IF 7.2 ) Pub Date : 2021-09-28 , DOI: 10.1016/j.joca.2021.08.011
A M Davis ₁ , R Wong ₂ , K Steinhart ₂ , L Cruz ₃ , D Cudmore ₄ , T Dwyer ₅ , L Li ₆ , P Marks ₇ , R McGlasson ₈ , N Urquhart ₉ , J A Wilson ₁₀ , L Nimmon ₁₁ , D Ogilvie-Harris ₁₂ , J Chahal ₁₃

Affiliation

Institute of Health Policy, Management and Evaluation and Department of Physical Therapy, University of Toronto, Toronto, Canada; Krembil Research Institute, University Health Network, Toronto, Canada.
Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada.
LiveActive Sport Medicine and Women's College Hospital, University of Toronto, Toronto, Canada.
Family and Sport Medicine, St. Francis Xavier University, Antigonish, and Department of Family Medicine, Dalhousie University, Halifax, Canada.
University of Toronto Orthopaedic Sports Medicine, Women's College Hospital College and Mount Sinai Hospital, University of Toronto, Toronto, Canada.
Arthritis Research Canada, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
University of Toronto Orthopaedic Sports Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Bone and Joint Canada, Toronto, Canada.
Dartmouth General Hospital, Orthopaedic Surgery, Dalhousie University, Halifax, Canada.
Department of Surgery, McMaster University, Hamilton, Canada.
Centre for Health Education Scholarship, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
University of Toronto Orthopaedic Sports Medicine, Women's College Hospital, University of Toronto, Toronto, Canada.
University of Toronto Orthopaedic Sports Medicine, Women's College Hospital, University of Toronto, and Schroeder Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada.

Introduction

Anterior cruciate ligament (ACL) injury is a risk factor for developing knee osteoarthritis (OA). We developed an intervention to support people manage risk factors for OA.

Methods

We conducted one-on-one interviews with 20 individuals with OA symptoms 6–15 years post ACL injury and used a nominal group process during a workshop with 40 patients and healthcare professionals (HCPs) to elicit information on the intervention content and delivery characteristics (timing, HCPs, and methods). Interview data were analyzed using content analysis. Nominal group ideas with importance ratings ≥5 of 7 met criteria for inclusion. Results were integrated, considering similarities and differences.

Results

Eight content categories were identified: 1. understanding knee injury and expectations about recovery; 2. understanding OA risk; 3. understanding OA signs and symptoms; 4. managing OA risk; 5. managing knee OA symptoms; 6. information for influencers; 7. credible sources; and, 8. updates on new evidence and treatments. Delivery timing reflected a lifespan approach from time of injury through symptomatic knee OA management. Although multiple media for delivery were identified, introductory face-to-face discussions and opportunity for re-accessing HCPs were critical. All HCPs who treat people with ACL should be familiar with and able to deliver the intervention.

Conclusions

This co-development approach identified that an intervention to support people with ACL injury to limit and manage knee OA requires content embedded within an easily accessible, multi-media delivery model with capacity for check-back with HCPs that is appealing to different age groups and personal preferences over the lifespan post injury.

中文翻译：

开发一种干预措施来管理前交叉韧带损伤后膝关节骨关节炎的风险和症状

介绍

前交叉韧带 (ACL) 损伤是发生膝关节骨关节炎 (OA) 的危险因素。我们开发了一种干预措施来支持人们管理 OA 的风险因素。

方法

我们对 20 名在 ACL 损伤后 6-15 年出现 OA 症状的人进行了一对一访谈，并在与 40 名患者和医疗保健专业人员 (HCP) 的研讨会期间使用了名义上的小组过程来获取有关干预内容和交付特征的信息。时间、HCP 和方法）。访谈数据采用内容分析法进行分析。重要性等级≥5（共 7 个）的标称组想法符合纳入标准。综合考虑相同点和不同点的结果。

结果

确定了八个内容类别： 1. 了解膝关节损伤和对康复的期望；2.了解OA风险；3. 了解 OA 的体征和症状；4.管理OA风险；5. 管理膝关节 OA 症状；6. 影响者信息；7. 可靠来源；8. 新证据和治疗方法的更新。分娩时间反映了从受伤到有症状的膝关节 OA 管理的寿命方法。尽管确定了多种交付媒体，但介绍性的面对面讨论和重新访问 HCP 的机会至关重要。所有治疗 ACL 患者的 HCP 都应该熟悉并能够提供干预措施。