Updated: Jan 12
Surgery should not be the first treatment choice for patients with osteoarthritis
Current evidence suggests that knee arthroscopic surgery is no better than other non-surgical intervention (i.e. exercise therapy or injections), or even sham surgery, for people with symptomatic mild to moderate osteoarthritis (Palmer et al., 2019) Surgery should only be considered after attempting high-value non-surgical care that includes exercise therapy, education, and weight management (if needed) (Bannuru et al., 2019)
2. Osteoarthritis can be prevented by managing modifiable risk factors
Strong evidence suggests that osteoarthritis can be prevented by addressing key modifiable risk factors (Whittaker et al., 2019). For instance, obesity-related metabolic factors contribute to osteoarthritis by including pro-inflammatory processes in cartilage and bone (Wang et al., 2015).
3. Exercise is safe and recommneded for osteoarthritis
Findings from the recent systematic review (Bricca et al., 2019), including more than 1700 participants, suggest that exercise therapy does not trigger inflammatory reactions nor harm articular cartilage in people with arthritis. There is evidence that exercise therapy can improve cartilage matrix content in people who were at high risk of osteoarthritis (Roos & Dahlberg 2005).
4. Joint structural damage does not fully explain osteoarthritis pain
A large proportion of people with osteoarthritis present manifestations of peripheral and central sensitisation, which have been linked to poorer clinical outcomes and prognosis (De Oliveira Silva et al., 2019). Also, psychological impairments including anxiety, depression, fear of movement and pain catastrophising are associated with disability and pain flares in people with osteoarthritis (Wise et al., 2009).