Use of Recommended Non-surgical Knee Osteoarthritis Management in Patients prior to Total Knee Arthroplasty: A Cross-sectional Study

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.

From the Department of Medicine, University of Toronto, Toronto, Ontario; Department of Community Health Sciences, University of Calgary, Calgary, Alberta; Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, Manitoba; Division of Orthopaedics, Department of Surgery, Dalhousie University and Queen Elizabeth II (QEII) Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. This study was funded by an operating grant from the Canadian Institutes of Health Research (grant no. MOP-312807). G.A. Hawker has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. D.A. Marshall is supported through a Canada Research Chair in Health Systems and Services Research and the Arthur J.E. Child Chair in Rheumatology. L.K. King, MBBS, MSc, Department of Medicine, University of Toronto; D.A. Marshall, PhD, Department of Community Health Sciences, University of Calgary; P. Faris, PhD, Department of Community Health Sciences, University of Calgary; L.J. Woodhouse, PT, PhD, Department of Physical Therapy, University of Alberta; C.A. Jones, PhD, Department of Physical Therapy, University of Alberta; T. Noseworthy, MD, MPH, Department of Community Health Sciences, University of Calgary; E. Bohm, MD, MSc, Concordia Hip & Knee Institute, University of Manitoba; M.J. Dunbar, MD, PhD, Division of Orthopaedics, Department of Surgery, Dalhousie University and QEII Health Sciences Centre, Nova Scotia Health Authority; G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto. Address correspondence to Dr. G.A. Hawker, Sir John and Lady Eaton Professor and Chair, Department of Medicine, University of Toronto, 190 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. E-mail: g.hawker{at}utoronto.ca. Accepted for publication November 5, 2019.