The proportions of people with OA that, according to the GP referral letter, had used one or more of the core treatment modalities (physiotherapy, supervised exercise, weight reduction, OA information and/or OA education programme) prior to orthopaedic referral, were calculated.

The proportion of people that, according to the GP referral letter, had been assessed using an MRI for decision making on joint replacement surgery, but not a conventional radiograph, were calculated. Those with no use of imaging were ignored.

Deviation from the protocol ( NCT02876120): We were unable to assess the proportion of people with OA referred to orthopaedic surgeon in secondary care that underwent scheduled joint surgery. This was due to not being able to determine relevant patient cases within the hospital’s ICT system.

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