# Traditional Korean Medicine Services and Its Association with Knee Surgery and Opioid Use in Patients with Knee Osteoarthritis: A Nationwide Retrospective Study in Korea

## TL;DR

This study found that traditional Korean medicine services may reduce the need for knee surgery and opioid use in patients with knee osteoarthritis.

## Contribution

The study provides empirical evidence on the impact of traditional Korean medicine on knee surgery and opioid use in knee osteoarthritis patients.

## Key findings

- TKMS group had significantly lower hazard ratios for knee surgery and opioid use.
- Results were consistent across different treatment windows in sensitivity analyses.
- TKMS may reduce reliance on high-risk medications and unnecessary surgeries.

## Abstract

Objectives: This study aimed to assess the impact of traditional Korean medicine services (TKMS) on subsequent knee surgery and opioid use in patients diagnosed with knee osteoarthritis (KOA). Methods: This retrospective cohort study used National Health Insurance Review and Assessment Service claims data from 2015 to 2017 to identify patients treated for KOA (M17) in 2016. Patients with at least two Korean medicine (KM) clinic visits within 6 weeks of the initial diagnosis formed the TKMS group, while those without visits to KM clinics formed the n group. Propensity score matching (PSM) (1:1) was applied and the incidence of knee surgery and opioid use was followed up for one year. Kaplan–Meier survival curves and Cox proportional hazards models estimated time-to-event outcomes and hazard ratios (HRs). Sensitivity analyses were performed to verify the results across varied treatment windows of 4, 8, and 10 weeks. Results: After PSM, 247,168 patients were included in the analysis for each group. The TKMS group exhibited significantly lower HRs for knee surgery (HR = 0.69, 95% CI: 0.66–0.72), opioid use (HR = 0.66, 95% CI: 0.65–0.66), and their compound events (HR = 0.66, 95% CI: 0.65–0.67) compared with the Non-TKMS group. The results remained consistent across sensitivity analyses. Conclusions: Among patients with KOA, the utilization of TKMS may significantly reduce the incidence of knee surgery and opioid use. Thus, the utilization of TKMS may be associated with a reduced need for unnecessary surgical interventions and with lower reliance on high-risk medications.