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Osteoarthritis (OA) has been thought of as a disease of cartilage that can be effectively treated surgically at severe stages with joint arthroplasty. Today, OA is considered a whole-organ disease that is amenable to prevention and treatment at early stages. OA develops slowly over 10-15 years, interfering with activities of daily living and the ability to work. Many patients tolerate pain, and many health-care providers accept pain and disability as inevitable corollaries of OA and ageing. Too often, health-care providers passively await final 'joint death', necessitating knee and hip replacements. Instead, OA should be viewed as a chronic condition, where prevention and early comprehensive-care models are the accepted norm, as is the case with other chronic diseases. Joint injury, obesity and impaired muscle function are modifiable risk factors amenable to primary and secondary prevention strategies. The strategies that are most appropriate for each patient should be identified, by selecting interventions to correct--or at least attenuate--OA risk factors. We must also choose the interventions that are most likely to be acceptable to patients, to maximize adherence to--and persistence with--the regimes. Now is the time to begin the era of personalized prevention for knee OA.

Original publication

DOI

10.1038/nrrheum.2015.135

Type

Journal article

Journal

Nature reviews. Rheumatology

Publication Date

02/2016

Volume

12

Pages

92 - 101

Addresses

Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark.

Keywords

Humans, Osteoarthritis, Knee, Obesity, Weight Loss, Body Mass Index, Treatment Outcome, Exercise Therapy, Risk Factors, Evidence-Based Medicine, Age Distribution, Sex Distribution, Aging, Denmark, Physical Therapy Modalities, Patient Education as Topic, Precision Medicine, United Kingdom