THERAPEUTIC APPROACHES OF GERMAN AND TURKISH PHYSICIANS TO RHEUMATOID-ARTHRITIS AND TO OSTEOARTHRITIS OF THE KNEE

Our objective was to compare the therapeutic approaches of German and Turkish physicians to rheumatoid arthritis (RA) and to osteoarthritis (OA) of the knee, by means of a mailed survey. The survey contained fo ur case histories representing a mild, a moderate and a severe case of RA and a case of OA of the knee. One hundred and thirty-to physicians from Germany (internal medicine based (IR) and orthopaedics based (OR ) rheumatologists) and thirty-three from Turkey (rheumatologists and p hysical medicine and rehabilitation specialists (PT) participated in t he study. German respondents would give more disease-modifying drugs ( DMARD) in early RA (48.7% vs 18.2%, p < 0.05), whereas their Turkish c olleagues would prescribe more analgesics, ultrasound and kryotherapy in OA of the knee (63.6% vs 22.1%, 30.3% vs 6.5% and 24.2% vs 0.0% res pectively p < 0.05). German physicians chose more exercise, physical a nd occupational therapy, radiation synovectomy and surgery in all case s. In OA of the knee German OR's would recommend less analgesics, but more local steroids, chondroprotective agents and surgery than the oth er groups. We may conclude that clinical practice of RA and OA of the knee differs considerably in Germany and Turkey. Cultural, social, edu cational and economic factors could influence the decisions of the phy sicians.