Friday, January 7, 2011
Doctors Not Following Guidelines for Knee Arthritis.
A January 2011 article to be published in Arthritis Care and Research suggests that doctors are ignoring the latest evidence-based guidelines and continuing to prescribe analgesics and refer patients for surgery.
This behavior is consistent with the "traditional" treatment of osteoarthritis - Take painkillers until the pain becomes unbearable then have the joint replaced.
This ignores the strong evidence supporting conservative non-pharmacological management of osteoarthritis. These treatments can be used during the period between diagnosis and end stage disease and aim to delay or prevent the need for surgery.
My personal opinion is that this occurrence is in part due to the culture of today. Treatments proven to benefit knee arthritis but requiring will power and hard work (exercise and weight loss programs), are less popular than "easy" treatments (oral pain medication and arthroscopic surgery) despite their relatively ineffectiveness.
Motivation is the key to success and this will be the challenge to governments looking to reduce the cost of osteoarthritis treatment. The analgesia-surgery model is unsustainable financially and it seems illogical to ignore treating the middle stage of the disease.
Lifestyle programs incorporating weight loss and exercise plus the use of assistive devices such as unloader knee braces will be the focus of future treatment programs as cost effectiveness becomes increasingly important.
I still see the occasional patient who asks for the facts, does every one of the proven treatments, and does very well. The majority however want the magic wand waved over them and all to be fine.
For more, read the article here.