Knee osteoarthritis (OA) is one of the most common degenerative diseases that cause disability in elderly people. An epidemiological study by Felson et al showed that about 30% of all adults have radiological signs of OA; 8.9% of the adult population has clinically significant OA of the knee or hip, of which knee OA was the most common type. The Chinese population has a similar prevalence rate. A nationwide population-based study in China showed an 8.1% total incidence rate of symptomatic knee OA and increasing prevalence of knee OA with age. It is estimated that the percentage of older adults in the Hong Kong population will increase from 16.6% in 2016 to 31.1% by 2036, and the prevalence of knee OA is expected to increase.
Although clinical guidelines for managing lower limb osteoarthritis (LLOA) in the primary care setting were proposed in Hong Kong in 2004, comparison with recently updated international guidelines shows some differences from management in Hong Kong. Therefore, it is of paramount importance to keep updating OA management guidelines so as to provide the best possible evidence-based management in the primary setting. This may help to delay progression into end-stage OA and thus decrease the need for arthroplasty and alleviate long waiting times (the average waiting time for arthroplasty in public hospitals in Hong Kong is 66 months).
The aim of the presentation is to compare and contrast the LLOA management guidelines proposed in Hong Kong with international guidelines, including the Osteoarthritis Research Society International (OARSI), the American Academy of Orthopaedic Surgeons (AAOS), and the American College of Rheumatology (ACR). The author will present the recent update in the management of osteoarthritis. The importance of patient education, exercise and weight management in the osteoarthritis management will be emphasized. Various controversial areas, including the role of glucosamine and chondroitin supplements, intra-articular viscosupplementation injection, arthroscopy, and joint preservation and replacement surgeries, will also be discussed.
The present abstract based on an article prepared by the presenting author
HS Kan, PK Chan, KY Chiu et al. Non-surgical management of knee osteoarthritis. Hong Kong Medical Journal, 2019 Mar 28 | https://doi.org/10.12809/hkmj187600
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