Evaluation of disease burden, patient journey, unmet diagnosis and treatment needs of patients with HIP and knee osteoarthritis in Turkey: A study through Delphi Methodology

Çay H. F., AKINCI A., ALTAN İNCEOĞLU L., ATAMAN Ş., AYDOĞDU S., Dıraçoğlu D., ...More

Osteoarthritis and Cartilage Open, vol.5, no.1, 2023 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 5 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1016/j.ocarto.2022.100332
  • Journal Name: Osteoarthritis and Cartilage Open
  • Journal Indexes: Scopus
  • Keywords: arthroplasty, diagnosis, disease burden, osteoarthritis, severity, treatment response
  • Hacettepe University Affiliated: Yes


Objective: To get information-driven insights from expert physicians regarding multiple aspects of the patient journey in knee and hip OA and establish a consensus for future studies and decision tree models in Turkey. Design: 157 questions were asked in total during this three-round modified Delphi-method panel to 10 physical medicine and rehabilitation specialists (2 have rheumatology and 3 have algology subspeciality), one orthopaedic surgeon and one algology specialist from anaesthesia specialty background. A consensus was achieved when 80% of the panel members agreed with an item. Contradictions between different disciplines were accepted as a non-consensus factor. Results: Panellists agreed that American College of Rheumatology classification criteria is mostly sufficient to provide an OA diagnosis in clinical practice, OA patients with ≥5 Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or physical function score can be defined as moderate-to-severe OA if they have an additional ≥2 Kellgren-Lawrence (KL) score, a minimum improvement of 30% from baseline in WOMAC pain or function subscales or in PGA score can be accepted as moderate treatment response where ≥50% improvement from baseline in those scores as substantial response. Panellists stated that arthroplasty procedures need to be delayed as long as possible, but this delay should not jeopardize a beneficial and successful operation. Conclusions: These findings show that there is a significant disease burden, unmet treatment needs for patients with moderate-to-severe OA in Turkey from experts’ perspective. Therefore, an updated systematic approach and decision tree models are needed to be implemented.