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Exploring views of orthopaedic surgeons, rheumatologists and general practitioners about osteoarthritis management

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journal contribution
posted on 17.01.2022, 05:35 by Jason WallisJason Wallis, Christian BartonChristian Barton, Natasha BruscoNatasha Brusco, Joanne KempJoanne Kemp, J Sherwood, K Young, S Jennings, A Trivett, IN Ackerman
Background: Delivery of recommended treatments for hip and knee osteoarthritis (OA) is known to be discordant with guideline recommendations. However, professional views related to OA management across medical and surgical disciplines are not well understood. The aim of this study was to explore the views of medical professionals about management of hip and knee OA. Methods: Qualitative study. Semistructured individual interviews were conducted with orthopaedic surgeons, rheumatologists and general practitioners routinely involved in the management of OA. Interviews were audiotaped, transcribed, member-checked, coded and thematically analysed. Results: Fifteen medical professionals were interviewed. Three main themes were: (i) recognition of the importance of nonsurgical management of hip and knee OA, focussed on self-management, exercise-therapy, weight management and analgesia; (ii) joint replacement being considered the ‘last resort' for end stage disease not responding to nonsurgical management; and (iii) determination of management ‘success' through patient perceptions was more common than the use of validated instruments. Views on management broadly converged across disciplines, except for the role of joint replacement, considered an adjunct in the overall management of OA by rheumatologists and as a definitive cure by orthopaedic surgeons. Conclusions: Aligning with current guidelines, medical professionals recognised the importance of nonsurgical management focussed on exercise-therapy for hip and knee OA, and concurred that joint replacement surgery should be a last resort. A focus on patient education was less prominent, which along with implementation of validated outcome measures in routine medical practice, may require greater health system support.

Funding

Cabrini Foundation, Grant/Award Number: ST042

History

Publication Date

01/12/2021

Journal

Musculoskeletal Care

Volume

19

Issue

4

Pagination

(p. 524-532)

Publisher

Wiley

ISSN

1478-2189

Rights Statement

© 2021 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.