India-Based Knee Osteoarthritis Evaluation (iKare): A Multi-Centre Cross-Sectional Study on the Management of Knee Pain and Early Osteoarthritis in India

Clin Orthop Surg. 2017 Sep;9(3):286-294. doi: 10.4055/cios.2017.9.3.286. Epub 2017 Aug 4.


Background: Access to early knee osteoarthritis treatment in low and middle income nations is often believed to be limited. We conducted a cross-sectional study in India to assess prior access to treatment among patients presenting with knee pain to specialist orthopaedic clinics.

Methods: The multi-centre, cross-sectional study included patients presenting with knee pain at 3 hospitals in India. Patients who met the inclusion criteria and provided informed consent completed a questionnaire designed to assess patient demographics, socioeconomic status, knee pain, treatment method, and patient's knowledge on osteoarthritis (OA). Their orthopaedic surgeons also completed a questionnaire on the severity of patient's OA and their recommended treatments. The impact of demographic characteristics on the prescription of treatment options was analyzed using logistic regression.

Results: A total of 714 patients met the eligibility criteria and participated in this study. The majority of patients had been experiencing pain for less than 1 year (64.8%) and had previously been prescribed medications (91.6%), supplements (68.6%), and nonpharmacological (81.9%) treatments to manage their knee OA. Current treatment recommendations included oral medications (83.3%), intra-articular injections (29.8%), and surgical intervention (12.7%). Prescription of oral medications was related to younger age, lack of deformities, and lower Kellgren-Lawrence grades (p < 0.01). Patients treated in private hospital settings were more likely to have been previously treated with medications (range, 84.3% to 92.6%; p < 0.01) and physical treatments (range, 61.8% to 84.8%; p < 0.01) than patients treated at government hospitals.

Conclusions: Contrary to the perception, our findings suggest a similar proportion of early knee OA treatment between India and North America.

Keywords: Cross-sectional studies; India; Knee; Osteoarthritis.

Publication types

  • Multicenter Study

MeSH terms

  • Analgesics / therapeutic use
  • Arthralgia / therapy*
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / therapy*
  • Pain Management / methods
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Time Factors


  • Analgesics