When should we treat knee osteoarthritis and with which treatments?

As few as one-in-five people with knee osteoarthritis use all recommended non-surgical treatments. 1 Mazzei DR Whittaker JL Kania-Richmond A et al. Do people with knee osteoarthritis use guideline-consistent treatments after an orthopaedic surgeon recommends nonsurgical care? A cross-sectional survey with long-term follow-up. Osteoarthr Cartil Open. 2022; 4100256 Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar One potential approach to increase the use of these treatments is to deliver a treatment package when people are awaiting total knee replacement surgery; a time when patients often experience worsening health and might be more likely to adhere to care. In The Lancet Rheumatology, A Hamish R W Simpson and colleagues evaluated the feasibility of an intervention package for people with knee osteoarthritis awaiting a primary total knee replacement. 2 Simpson AHRW Clement ND Simpson SA et al. A preoperative package of care for osteoarthritis, consisting of weight loss, orthotics, rehabilitation, and topical and oral analgesia (OPPORTUNITY): a two-centre, open-label, randomised controlled feasibility trial. Lancet Rheumatol. 2024; (published online Feb 26.)https://doi.org/10.1016/S2665-9913(23)00337-5 Summary Full Text Full Text PDF Scopus (2) Google Scholar A preoperative package of care for osteoarthritis, consisting of weight loss, orthotics, rehabilitation, and topical and oral analgesia (OPPORTUNITY): a two-centre, open-label, randomised controlled feasibility trialParticipants adhered well to the non-operative interventions and their health-related quality of life improved. Participant and health professional feedback were extremely positive. These findings support progression to a full-scale effectiveness trial. Full-Text PDF Open Access