New guide to reduce surgery

THE Royal Australian College of General Practitioners (RACGP) has updated its guideline for the management of knee and hip osteoarthritis, aiming to reduce over-reliance on measures such as surgery, imaging technology and medication.

University of Sydney School of Medicine rheumatology clinician researcher and co-Chair of the guideline development working group for the RACGP’s Professor David Hunter has put a new slant on treatments.

“The general philosophy of, ‘This is just old age, it’s wear and tear, there’s nothing we can do about it’, often times is inaccurate, but it also doesn’t help the patient to manage their disease,” Hunter told newsGP.

“It really discourages people from proactively managing [osteoarthritis] when we know there’s a lot they can do to help make themselves better.

“So we’re trying to encourage people not to use that sort of language and to improve the proactive management of the disease.”

The guideline, updated for the first time in eight years and approved by the National Health and Medical Research Council, has been designed to reflect changing evidence in the field of treatment for osteoarthritis.

Based on latest research data, the guideline ranks preventive and lifestyle treatments for most cases over prior suggestions of medication, surgery or treatments such as acupuncture.

“We emphasise lifestyle and behavioural interventions, such as exercise and weight loss, as the first line of management,” Hunter said.

The new guide pans treatments including glucosamine, opioids and arthroscopic surgery, which “cost the healthcare system a lot of money and don’t actually make people any better” - racgp.org.au.