Osteoarthritis and cartilage open · 2025
Management of glenohumeral osteoarthritis in the younger patient: A population level analysis of usual care delivery in a large health system.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rhon Daniel I, Horn Maggie E, Milan Rebecca, George Steven Z
Аннотация
OBJECTIVE: To characterize healthcare utilization in a younger population with glenohumeral osteoarthritis.
METHODS: Adults seeking care for glenohumeral osteoarthritis between July 2013 and March 2019 were analyzed. Ambulatory visits, pharmacological, and non-pharmacological treatment, and surgical and radiological procedures, were compared by active-duty status and sex. The association between exercise therapy receipt and subsequent surgery was modeled using an adjusted logistic regression, reporting adjusted odds ratios (OR).
RESULTS: There were 21,369 individuals (29.4 % female; mean age 50.3 [standard deviation (SD) 9.9] years), with 24.1 % military patients. The mean number of ambulatory shoulder visits per patient was 9.4 (SD 12.5). For pharmacological care 26.2 % received an injection, 14.8 % received non-steroidal anti-inflammatory drugs, 13.4 % opioids, 11.8 % muscle relaxants, and 9.9 % other analgesics. Non-pharmacological care included 44.5 % receiving exercise therapy, 41.6 % physiotherapy, and 32.6 % manual therapy, while 54.0 % received none of these. Radiographs were obtained for 51.3 % and advanced imaging for 47.1 %. Arthroscopic surgery occurred in 18.9 % and arthroplasty in 0.2 %. Military patients received less pharmacological and more non-pharmacological treatment that non-military patients. Males had 1.5x the odds of surgery and higher pharmacological treatment use than females. Receipt of exercise therapy (adjusted OR = 0.01; 95 % confidence interval 0.01, 0.02) significantly reduced the odds of arthroscopic surgery.
CONCLUSION: Many patients received no interventions. For those receiving care, <50 % received guideline-recommended non-pharmacological care, including exercise therapy which significantly reduced the likelihood of surgery. Military patients had overall less pharmacological but more non-pharmacological treatment than non-military patients. A greater frequency of males had surgery. These findings indicate the need to further explore health care delivery for glenohumeral osteoarthritis in younger populations, highlighting potential guideline to practice gaps.
METHODS: Adults seeking care for glenohumeral osteoarthritis between July 2013 and March 2019 were analyzed. Ambulatory visits, pharmacological, and non-pharmacological treatment, and surgical and radiological procedures, were compared by active-duty status and sex. The association between exercise therapy receipt and subsequent surgery was modeled using an adjusted logistic regression, reporting adjusted odds ratios (OR).
RESULTS: There were 21,369 individuals (29.4 % female; mean age 50.3 [standard deviation (SD) 9.9] years), with 24.1 % military patients. The mean number of ambulatory shoulder visits per patient was 9.4 (SD 12.5). For pharmacological care 26.2 % received an injection, 14.8 % received non-steroidal anti-inflammatory drugs, 13.4 % opioids, 11.8 % muscle relaxants, and 9.9 % other analgesics. Non-pharmacological care included 44.5 % receiving exercise therapy, 41.6 % physiotherapy, and 32.6 % manual therapy, while 54.0 % received none of these. Radiographs were obtained for 51.3 % and advanced imaging for 47.1 %. Arthroscopic surgery occurred in 18.9 % and arthroplasty in 0.2 %. Military patients received less pharmacological and more non-pharmacological treatment that non-military patients. Males had 1.5x the odds of surgery and higher pharmacological treatment use than females. Receipt of exercise therapy (adjusted OR = 0.01; 95 % confidence interval 0.01, 0.02) significantly reduced the odds of arthroscopic surgery.
CONCLUSION: Many patients received no interventions. For those receiving care, <50 % received guideline-recommended non-pharmacological care, including exercise therapy which significantly reduced the likelihood of surgery. Military patients had overall less pharmacological but more non-pharmacological treatment than non-military patients. A greater frequency of males had surgery. These findings indicate the need to further explore health care delivery for glenohumeral osteoarthritis in younger populations, highlighting potential guideline to practice gaps.