Updated recommendations on knee osteoarthritis management: The Hong Kong College of Orthopaedic Surgeons position...

To inform the public and medical practitioners about the effectiveness of various management regimens for knee osteoarthritis (knee OA), the Hong Kong College of Orthopaedic Surgeons (HKCOS) published a position statement in 2022. This study aimed to present the findings from expert consensus surveys conducted in 2022 and 2024, which form the basis of the recommendations in the position statement.

Fellows of the HKCOS, who were listed in the Specialist Register (Orthopaedics and Traumatology) of the Hong Kong Medical Council, were invited via email to participate in online surveys in 2022 and 2024. The surveys collected opinions on 26 interventions for the treatment of knee OA. Expert panellists were instructed to provide their recommendation for each intervention using one of three options: 'Recommend', 'Do not recommend' or 'Abstain'. A consensus of opinion was defined as a minimum of 70% agreement among the expert panellists.

A total of 106 expert panellists participated in the 2022 survey, and 28 participated in the 2024 survey. Consensus was reached among the expert panellists for 14 interventions in 2022 and 13 interventions in 2024. In both surveys, the expert panel reached consensus in recommending the following treatments for knee OA: patient education, land-based exercise, water-based exercise, self-management programme, weight reduction, use of a cane, oral paracetamol, topical non-steroidal anti-inflammatory drugs, oral non-steroidal anti-inflammatory drugs, high tibial osteotomy, and joint replacement surgery. Conversely, the expert panel reached consensus in recommending against the use of lateral wedge insoles and denervation therapy.

Findings from both the 2022 and 2024 surveys demonstrated consistent expert consensus on key recommended and non-recommended interventions for knee OA. The recommendations provide evidence-based guidance to the public and medical practitioners regarding the effectiveness of various management strategies for knee OA.