Knee osteoarthritis in Australia: A 20-year case study of funding-system failure with poor outcomes

As long as 20 years ago, there was evidence that knee arthroscopy was an ineffective treatment for knee osteoarthritis. Yet Australia continues to generously fund ineffective treatments like knee arthroscopy and opioid drugs for knee osteoarthritis and continues to underfund exercise-based management. Although guidelines have changed to emphasise exercise-based treatments and discourage knee arthroscopy and opioid prescription, this has not been backed up by reform of funding incentives. Poor funding decisions in Australia have contributed to Australia having the world's highest age-standardised rate of knee replacements.