A roadmap for developing a program to self-manage post-traumatic knee osteoarthritis risk

Youth and young adults who experience a traumatic knee injury (i.e., ligament, meniscus, or cartilage injury; intra-articular fracture or dislocation) have a 6-fold elevated risk of early-onset post-traumatic knee osteoarthritis (PTOA), contributing to joint pain and disability for most of their adult lives. This reality represents a daunting personal and societal burden. Currently, there is no proven clinical program that supports individuals at-risk of PTOA self-manage their knee health and reduce their risk, despite evidence that interventions supporting exercise, physical activity, and healthy body composition have promise. This paper describes the development of the Stop OsteoARthritis (SOAR) Program, a multi-component, virtual program that integrates education, behaviour change techniques, tailored progressive exercise and physical activity, self-monitoring, and regular physiotherapist interactions. Guided by the Consolidated Framework for Implementation Research, we describe and reflect on our iterative process for 1) identifying key elements and strategies to self-managing knee health and PTOA risk, 2) developing a program to deliver these elements and strategies, and 3) exploring barriers, facilitators, and opportunities to implementing the program in clinical settings. This information provides a roadmap for developing other programs aimed at reducing the enormous burden of musculoskeletal conditions.