Evaluation of the effect of a three-color ladder management model for knee osteoarthritis in the community

Abstract

Objective: To explore the application effect of a three-color ladder management system for knee osteoarthritis in the community.

Methods: Eighty-six patients with knee osteoarthritis in our community were obtained for study and randomly grouped. The control group received routine management, while the research group received three-color ladder management for 12 months. The knee joint function (WOMAC score), pain degree (VAS score), joint flexibility, health-related behavior score, self-care ability scale (exercise of self-care agency scale (ESCA) score), quality of life (knee osteoarthritis quality of life scale (AIMS2-SF) score) and knee replacement rate were compared between the two groups before and after management, and the changes of patients' visits and treatment costs before and after management were observed.

Results: After 12 months, the scores of WOMAC and VAS in the research group were significantly lower than those of the control group (P<0.05), while the scores of joint flexibility and extension, cognition, behavior and condition of Omaha System health-related behaviors, ESCA and AIMS2-SF were significantly higher than those of the control group (P<0.05). After 12 months, the monthly visits and expenses of green cards, yellow cards and red cards in the research group were significantly lower than those before entering the group (P<0.05). After 12 months, the knee replacement rate was 20.93% (9/43) in the research group, while it was 27.91% (12/43) in the control group, with no significant difference between the two groups (P>0.05).

Conclusion: The three-color ladder management system for knee osteoarthritis patients in the community can reduce the number of doctor visits and overall expenses, improve knee joint function, reduce pain, improve self-management ability and quality of life, and it has high community popularization.

Keywords: Community; knee osteoarthritis; quality of life; three-color ladder.

Figure 1

Comparison of VAS scores and joint flexion and extension activities between the two groups. A: VAS score; B: Joint flexion and extension range of motion. Compared with this group when entering the group, **P<0.01, ***P<0.001; compared with the control group, #P<0.05, ###P<0.001.

Figure 2

Scores of cognition, behavior and status of health-related behaviors in Omaha system. A: Cognitive score; B: Behavior score; C: Condition score. Compared with this group when entering the group, ***P<0.001; compared with the control group, ###P<0.001.

Figure 3

Comparison of ESCA and AIMS2-SF scores between the two groups. A: ESCA score; B: AIMS2-SF score. Compared with this group when entering the group, *P<0.05, **P<0.01, ***P<0.001; compared with the control group, #P<0.05, ##P<0.01. AIMS2-SF: knee osteoarthritis quality of life scale; ESCA: exercise of self-care agency scale.