Factors associated with patients' willingness to consider joint surgery after completion of a digital osteoarthritis treatment program : A prospective cohort study

OBJECTIVES: To examine patient willingness and possible shift in willingness for surgery and to investigate factors associated with this shift, following participation in the digital non-surgical osteoarthritis (OA) treatment program Joint Academy.METHODS: 458 individuals (mean age 62±5.6 years, 67% women) with diagnosed hip or knee were evaluated after six weeks in Joint Academy, comprising education and exercise as well as asynchronous chat with a physical therapist. Data describing joint pain, health-related quality of life (EQ-5D-3L), walking difficulties, 30-second Chair Stand Test (30CST) and willingness to consider surgery were collected at baseline and at six weeks.RESULTS: At follow-up, 31% of those willing to consider surgery at baseline no longer considered surgery. Of those who were unwilling to consider surgery at baseline, 6% re-considered and considered surgery at follow-up. Less pain and a higher EQ-5D-3L index at six weeks were associated with the shift from being willing to unwilling to consider surgery at follow-up (OR=0.67-1.64, p<0.05). Worse pain, a lower EQ-5D-3L index and having walking difficulties at six weeks, and a lower pain and EQ-5D-3L index improvement were associated with the shift from being unwilling to willing to consider surgery at six weeks (OR=0.51-4.30, p