New international guidelines for the non-surgical treatment of osteoarthritis were presented at the ORTHOGEN Lunch Symposium ‘Conservative Management of Knee Osteoarthritis’. Strengthening conservative methods for avoiding surgical interventions – under the motto ‘Avoiding surgery, relieving pain, promoting healing’.
In Germany, according to experts Peter Wehling and Timothy McAlindon there are demand and need for strengthening the so-called conservative therapies to avoid surgery. In its published guidelines, the Osteoarthritis Research Society International (OARSI) advocates strengthening of conservative treatment for knee osteoarthritis. ‘About two million people in Germany suffer from osteoarthritis of the joints. Due to the frequency of the condition and the often unsatisfactory outcomes, the need for alternative, safe and effective orthopaedic treatment methods is very high’, concluded Prof. Wehling during the German Congress of Orthopaedic and Trauma surgeons (DKOU).
Rheumatologist Prof. Dr. Timothy McAlindon from Tufts University School of Medicine, Boston University, reported on the current state of the international guidelines of the Osteoarthritis Research Society International (OARSI) for the treatment of gonarthrosis in conservative osteoarthritis treatment. Professor McAlindon explained how the guidelines are implemented into daily practice by the US specialists, noting that ‘some guidelines still have conflicting recommendations, for example concerning treatment with hyaluronic acid, which is quite relevant for clinical practice and for treatment results in patients.’ For example, the new guidelines of the American Association of Orthopaedic Surgeons (AAOS) advise, due to lack of proven efficacy, against injection of hyaluronic acid preparations into the affected joints for treatment of osteoarthritis.
Prof. Wehling evaluated the clinical trial situation on osteoarthritis therapy with surgery, cortisone, hyaluronic acid, PRP, ACS, mesenchymal stem cells and gene therapy in detail. In particular, the cost-effectiveness of total endoprostheses (TEP) and other widely-used surgical procedures and the scientific evidence of each method compared to conservative alternatives were central themes of his lecture. The published study results of conservative treatment methods such as intra-articular injection of autologous, anti-inflammatory substances were evaluated by Professor Wehling based on clinical evidence. In the future, strengthening of conservative therapy should be considered in the German guidelines for the treatment of osteoarthritis as well, as it is already the case in many other international guidelines. Furthermore, Prof. Wehling talked about the increasing ageing of the population and the related future challenges in the diagnosis and treatment of osteoarthritis.