Exploring views of orthopaedic surgeons, rheumatologists and general practitioners about osteoarthritis management. 2021

Jason A Wallis, and Christian J Barton, and Natasha K Brusco, and Joanne L Kemp, and James Sherwood, and Kirby Young, and Sophie Jennings, and Adrian Trivett, and Ilana N Ackerman
Centre for Allied Health Research and Education, Cabrini Health, Malvern, Victoria, Australia.

Delivery of recommended treatments for hip and knee osteoarthritis (OA) is known to be discordant with guideline recommendations. However, professional views related to OA management across medical and surgical disciplines are not well understood. The aim of this study was to explore the views of medical professionals about management of hip and knee OA. Qualitative study. Semistructured individual interviews were conducted with orthopaedic surgeons, rheumatologists and general practitioners routinely involved in the management of OA. Interviews were audiotaped, transcribed, member-checked, coded and thematically analysed. Fifteen medical professionals were interviewed. Three main themes were: (i) recognition of the importance of nonsurgical management of hip and knee OA, focussed on self-management, exercise-therapy, weight management and analgesia; (ii) joint replacement being considered the 'last resort' for end stage disease not responding to nonsurgical management; and (iii) determination of management 'success' through patient perceptions was more common than the use of validated instruments. Views on management broadly converged across disciplines, except for the role of joint replacement, considered an adjunct in the overall management of OA by rheumatologists and as a definitive cure by orthopaedic surgeons. Aligning with current guidelines, medical professionals recognised the importance of nonsurgical management focussed on exercise-therapy for hip and knee OA, and concurred that joint replacement surgery should be a last resort. A focus on patient education was less prominent, which along with implementation of validated outcome measures in routine medical practice, may require greater health system support.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072140 Rheumatologists Physicians who specialize in treating RHEUMATIC DISEASES. Rheumatologist
D000072161 Orthopedic Surgeons Physicians specializing in medical, surgical, and physical methods used to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures. Orthopedists,Orthopedic Surgeon,Orthopedist,Surgeon, Orthopedic,Surgeons, Orthopedic
D015207 Osteoarthritis, Hip Noninflammatory degenerative disease of the hip joint which usually appears in late middle or old age. It is characterized by growth or maturational disturbances in the femoral neck and head, as well as acetabular dysplasia. A dominant symptom is pain on weight-bearing or motion. Coxarthrosis,Osteoarthritis of the Hip,Osteoarthritis Of Hip,Coxarthroses,Hip Osteoarthritis,Osteoarthritis Of Hips
D058005 General Practitioners Physicians whose practice is not restricted to a specific field of MEDICINE. Physicians, General Practice,General Practice Physician,General Practice Physicians,General Practitioner,Physician, General Practice,Practice Physicians, General,Practitioner, General,Practitioners, General
D020370 Osteoarthritis, Knee Noninflammatory degenerative disease of the knee joint consisting of three large categories: conditions that block normal synchronous movement, conditions that produce abnormal pathways of motion, and conditions that cause stress concentration resulting in changes to articular cartilage. (Crenshaw, Campbell's Operative Orthopaedics, 8th ed, p2019) Osteoarthritis of Knee,Osteoarthritis of the Knee,Knee Osteoarthritides,Knee Osteoarthritis

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