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Strategies for the prevention of knee osteoarthritis
1Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark.
Abstract:
Osteoarthritis (OA) has been thought of as a disease of cartilage that can be effectively treated surgically at severe stages with joint arthroplasty. Today, OA is considered a whole-organ disease that is amenable to prevention and treatment at early stages. OA develops slowly over 10-15 years, interfering with activities of daily living and the ability to work. Many patients tolerate pain, and many health-care providers accept pain and disability as inevitable corollaries of OA and ageing. Too often, health-care providers passively await final 'joint death', necessitating knee and hip replacements. Instead, OA should be viewed as a chronic condition, where prevention and early comprehensive-care models are the accepted norm, as is the case with other chronic diseases. Joint injury, obesity and impaired muscle function are modifiable risk factors amenable to primary and secondary prevention strategies. The strategies that are most appropriate for each patient should be identified, by selecting interventions to correct--or at least attenuate--OA risk factors. We must also choose the interventions that are most likely to be acceptable to patients, to maximize adherence to--and persistence with--the regimes. Now is the time to begin the era of personalized prevention for knee OA.
Insights
Osteoarthritis (OA) is a whole-organ disease, not just cartilage damage. Early, personalized prevention strategies focusing on modifiable risk factors are crucial for managing this chronic condition.
Area of Science:
- Orthopedics
- Rheumatology
- Gerontology
Background:
- Osteoarthritis (OA) was historically viewed as a cartilage disease treatable with surgery in severe stages.
- Current understanding recognizes OA as a whole-organ disease requiring early intervention and prevention.
- Delayed treatment often leads to significant pain, disability, and the need for joint replacements.
Purpose of the Study:
- To shift the paradigm of OA management from late-stage surgical intervention to early, comprehensive prevention.
- To emphasize the importance of personalized prevention strategies for knee OA.
- To highlight modifiable risk factors and patient adherence in OA management.
Main Methods:
- Review of current understanding of OA as a chronic, whole-organ disease.
- Identification of modifiable risk factors including joint injury, obesity, and impaired muscle function.
- Emphasis on personalized intervention selection for patient adherence and persistence.
Main Results:
- OA develops over 10-15 years, impacting daily living and work capacity.
- Many patients and providers accept OA pain and disability as inevitable with aging.
- Early and comprehensive care models, similar to other chronic diseases, are advocated.
Conclusions:
- A proactive approach to OA prevention and management is necessary.
- Personalized prevention strategies targeting modifiable risk factors are key for knee OA.
- The era of personalized prevention for knee OA should commence, prioritizing patient adherence.
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