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Functional improvement not seen with care navigation after TKA in patients with OA
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At 6 months following total knee arthroplasty for osteoarthritis, patients were unlikely to have better functional improvements overall with interviewing-based care navigation according to results of this study. Findings showed, however, this type of navigation may be beneficial to more targeted subgroups.
Elena Losina, PhD, and colleagues performed a parallel randomized controlled trial in 308 patients who underwent total knee arthroplasty for osteoarthritis (OA). Out of the 308 patients, 154 patients were assigned to postoperative care with follow-ups that involved a care navigator and 154 patients were assigned to usual care. Researchers used the difference in WOMAC function scores over 6 months following surgery between care navigators and usual care as the primary outcome.
Investigators conducted a preplanned analysis of subgroups to differentiate efficacy of obesity and of exploratory subgroup analyses on gender and pain catastrophizing.
Results showed the mean preoperative WOMAC function score was 41 and at 6 months there it improved to 30 points and 27 points in the care navigation and usual care groups, respectively.
“Subjects assigned to the navigation intervention did not demonstrate greater functional improvement compared to those in the control group,” Losina and colleagues wrote.
Patients who were unlikely to benefit from navigation had moderate to high levels of pain catastrophizing, they noted in the results. ‒ by Monica Jaramillo
Disclosures: The study was supported by the NIH/ National Institute of Arthritis and Musculoskeletal and Skin diseases (grant K24-AR-057827).
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