New Treatment Paradigm Suggested for Osteoarthritis

Among the top risk factors for developing osteoarthritis—obesity, aging, and genetics—excess weight on the bones is the easiest to modify yet it continues to plague a large portion of the population. Other risk factors include family history, major injury or surgery to the knee or hip, and malalignment of the joints. Joint malalignment, often seen as bowleggedness, can make matters much worst for an overweight person, notes Dr. Iversen.

Fix It or Prevent It

Getting people to think about things as basic as maintaining healthy body weight throughout life could have a major impact on a significant portion of people who develop OA, says Dr. Chang.

“If we were able to wipe out obesity, some epidemiologists think that we might be able to prevent about one-third of all the knee osteoarthritis that we have in the world,” he says.

It may sound simple but it won’t be easy, says David T. Felson, MD, professor of medicine and epidemiology at Boston University School of Medicine, and a clinical researcher who studies OA risk factors and prevention opportunities. Convincing people to lose weight and increase physical activity poses a huge challenge to medical professionals and advocates alike.

“Those aren’t popular treatments that people willingly adopt and adhere to,” says Dr. Felson. “Those are very difficult things for people to do. There needs to be some concerted effort on the part of practitioners in the learning process for patients to sort of come to grips with the fact that they need to do those things.”

The message of prevention is often a hard sell to young customers. Just try telling someone in their 30s to modify his or her lifestyle or face the possibility of an arthritic knee 10 to 20 years down the road, says Dr. Mahomed.

“People are not going to be open to those sorts of things unless there’s a much deeper understanding of the implications of it,” says Dr. Mahomed.

Another possible obstacle is that the success and advances in joint replacement surgery may create the unwanted impression among the general population that there’s no need for prevention, says Dr. Iversen.

“We would like to be able to look at preventive techniques so that people don’t get to that stage where they are seeking total joint replacement,” says Dr. Iversen.