Joint Action

Studies have shown that the rates of joint replacement surgeries has increased steadily over the past decade. In Australia alone, there are about 110,000 joint replacements performed every year. This number is expected to rise with the aging population and increasing rates of obesity. Furthermore, COVID-related cancellations and hospital restrictions will likely impact the provision of joint replacements for years to come. Although joint replacement surgery is an effective treatment for end-stage osteoarthritis, the volume of joint replacement surgeries being places a huge burden on the surgical workforce and the healthcare system.

Ilana Ackerman is a Professor (Research) in the School of Public Health and Preventive Medicine at Monash University and a Deputy Director of the Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology. Ilana is a musculoskeletal epidemiologist and an experienced orthopaedic physiotherapist. She completed her PhD at The University of Melbourne in 2006. Over the past 15 years, Ilana has led a program of clinical and population-based research designed to quantify osteoarthritis impacts and joint replacement trends to inform optimal patient care.

RESOURCES

Journal articles

• The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030
• Actual versus Forecast Burden of Primary Hip and Knee Replacement Surgery in Australia: Analysis of Data from the Australian Orthopaedic Association National Joint Replacement Registry
• Lifetime Risk of Primary Shoulder Arthroplasty From 2008 to 2017: A Population-Level Analysis Using National Registry Data

Websites

• Orthoanswer
• AAOS

CONNECT WITH ILANA

• Twitter @IlanaAckerman

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

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Staying physically active is not only important for people with osteoarthritis, but all adults. Participating in physical activity can help improve mobility, physical conditioning and reduce the risk of falls. However, despite the numerous health benefits of staying physically active, many older adults do not meet the recommended guidelines. We know it is often hard staying active so wanted to unpack that and give some tips and tricks for staying active. In this week’s episode of Joint Action, we are joined by Mariana Wingood to discuss how we can increase our levels of physical activity.  

Mariana is a physiotherapist who received her Doctorate in Physical Therapy from SUNY Upstate Medical University in 2012. In 2014, she became a Certified Exercise Expert of Aging Adults, in 2015 a Geriatric Certified Specialist, and in 2021, she completed her PhD in Interprofessional Health Sciences and her Masters in Public Health. Mariana’s research interests are related to physical activity and aging, with a focus on addressing physical activity prescription barriers identified by outpatient physical therapists treating individuals 50 years and older. 

RESOURCES

Journal articles 

• Physical Activity and Physical Activity Participation Barriers Among Adults 50 years and Older During the COVID-19 PandemicThe Inventory of Physical Activity Barriers for Adults 50 Years and Older: Refinement and Validation  
• Community-Dwelling Older Adults and Physical Activity Recommendations: Patterns of Aerobic, Strengthening, and Balance Activities  
• Feet/Footwear-Related Fall Risk Screening Tool for Older Adults: Development and Content Validation 
• APTA Geriatrics’ Guiding Principles for Best Practices in Geriatric Physical Therapy: An Executive Summary 
• Pain Neuroscience Education for Older Adults 

Websites

• Go4Life
• Vivifrail
• National Council on Aging

CONNECT WITH MARIANA

• Twitter @elevatingEBP

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

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Osteoarthritis commonly affects the knee joint, which consists of three compartments – the medial tibiofemoral compartment, lateral tibiofemoral compartment and the patellofemoral compartment. Osteoarthritis can affect these compartments in isolation or in combination. Although, the majority of osteoarthritis research has focused on the tibiofemoral joints, patellofemoral OA is more prevalent and associated with greater pain and disability. On this week’s episode of Joint Action, we are joined by Dr Marieke van Middelkoop to discuss patellofemoral OA, including its prevalence, burden, diagnosis and treatments.

Dr. Marienke van Middelkoop is a human movement scientist and an associate professor at the Department of General Practice at Erasmus MC Medical University Rotterdam, The Netherlands. She received her PhD in 2008 on the subject ‘Running injuries’ at the Erasmus MC Medical University Rotterdam, The Netherlands.

She is currently the project leader of multiple PhD students and is the coordinator of the Osteoarthritis (OA) Trial Bank, an international successful ongoing project including a databank of more than 60,000 OA patients. She is a deputy editor of British Journal of Sports Medicine and in 2010 she was selected to participate in the Oxford International Primary Care Research Leadership Program.

RESOURCES

Journal articles

·     International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment

·     Is patellofemoral pain a precursor to osteoarthritis?: Patellofemoral osteoarthritis and patellofemoral pain patients share aberrant patellar shape compared with healthy controls

·     Medical Interventions for Patellofemoral Pain and Patellofemoral Osteoarthritis: A Systematic Review

·     Obesity is related to incidence of patellofemoral osteoarthritis: the Cohort Hip and Cohort Knee (CHECK) study

·     Incidence, prevalence, natural course and prognosis of patellofemoral osteoarthritis: the Cohort Hip and Cohort Knee study

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

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Obesity is a major risk factor for developing knee osteoarthritis and subsequently undergoing total knee replacement (TKR). The rates of obesity have increased dramatically over the past decades and in many developed nations, about two third of adults are above a healthy weight. Although TKR is a cost-effective treatment for end-stage osteoarthritis, the rising rates of obesity are resulting in more knee replacements and being performed at a younger age. On this week’s episode of Joint Action, we are joined by Chris Vertullo to discuss the rising rates obesity, their relation to TKR and what we can do about it.

Professor Chris Vertullo has been a specialist orthopaedic knee surgeon since 2001. He is the Director and Treasurer of the Australian Orthopaedic Association, current Past President of the Australian Knee Society, Chair of AOA Continuing Orthopaedic Education and an Adjunct Professor at Griffith University. He is currently listed amongst the top 100 orthopaedic influencers in the world. He is involved in the treatment of elite athletes and professional sports teams as well as being a strong advocate for sports injury prevention at a national level. He has a strong focus on research into knee surgery - founding Knee Research Australia and holds a PhD in the area of improving the outcomes of knee replacement.

*Correction* In the podcast, we mentioned that about two thirds of people receiving a joint replacement are overweight or obese. This is incorrect, two thirds of Australian adults are overweight or obese. About 90% of people undergoing TKR are overweight or obese.

RESOURCES

Websites

• MyJointPain
• OARSI Joint Effort Initiative
• Arthritis Australia

Journal articles

• Obesity is associated with an increased risk of undergoing knee replacement in Australia
• Effect of Bariatric Surgery on Risk of Complications After Total Knee Arthroplasty

Related episodes

• Losing weight and osteoarthritis - why and how? with Dr Stephen Messier
• The role of bariatric surgery for people with osteoarthritis with Dr Jonathan Samuels

CONNECT WITH CHRIS

• Web: http://www.knee-surgeon.net.au/
• Twitter: @Knee_Surgeon

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Joint injury is a major risk factor for developing osteoarthritis. For any given knee injury, about 50% of people will go on to develop osteoarthritis, regardless of if they have had surgical intervention or not. Osteoarthritis which follows a significant joint injury is sometimes called “post-traumatic osteoarthritis” or “PTOA” – many believe that PTOA represents a disease subgroup or phenotype of osteoarthritis. Joint injury is usually well-defined and easy to pinpoint in time allowing opportunities to better understand the early mechanisms of OA. Preclinical research has provided further insights on the development of PTOA and how certain molecules and pathways can be targeted to reduce or prevent OA following a joint injury. On this week’s episode of Joint Action, Dr Fiona Watt joins us to discuss prevention of osteoarthritis following injury.

Fiona is a Clinical Reader in Rheumatology in the Department of Immunology and Inflammation at Imperial College London, having previously been an Associate Professor at the Kennedy Institute of Rheumatology at the University of Oxford for a number of years, where she had completed her PhD in cartilage biochemistry in 2009. She was appointed as an honorary consultant rheumatologist in 2013. She leads the Clinical Translation theme within the Centre for Osteoarthritis Pathogenesis funded by Versus Arthritis. In 2019 she was awarded a UKRI Future Leaders Fellowship. Her research interest aims to develop new predictive tests and treatments in high risk groups for osteoarthritis.

RESOURCES

Journal articles

·     Prevention of posttraumatic osteoarthritis at the time of injury: Where are we now, and where are we going?

·     Posttraumatic osteoarthritis: what have we learned to advance osteoarthritis?

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

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The knee joint consists of three distinct joint compartments – the medial tibiofemoral (or inside), the lateral tibiofemoral (outside) and the patellofemoral (behind the kneecap). Braces or orthoses are devices made from lightweight materials which alter the biomechanics of the lower limb and alter the alignment of a joint. Research has shown that using an appropriate knee brace can reduce pain and improve function in people with osteoarthritis. Dr Howard Hillstrom joins us on this week's episode to discuss how braces can help knee osteoarthritis.

Dr Howard Hillstrom has a background as a biomedical engineer with over 26 years of experience in directing motion analysis laboratories. Howard is currently the director of the Motion Analysis Laboratory at Hospital for Special Surgery in New York. Howard has a strong background in the biomechanics of human movement with special attention to the lower extremity and related pathologies, such as osteoarthritis.

RESOURCES

 Journal articles

• Knee Osteoarthritis: Primary Care Using Noninvasive Devices and Biomechanical Principles
• Effects of a Medial Knee Unloading Implant on Tibiofemoral Joint Mechanics During Walking
• Development and validation of a computational model of the knee joint for the evaluation of surgical treatments for osteoarthritis. 
• Are joint structure and function related to medial knee OA pain? A pilot study. 

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

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There are a lot of descriptors used for osteoarthritis pain related to the character of pain, its distribution or location, its severity, its frequency - in particular, whether this is constant or intermittent.

New research into these pain patterns has shown that the different pain patterns experienced lead to different clinical outcomes in people with knee OA. If we can identify why some people have more constant or more severe pain, it might provide insights on which to intervene. This promising area of research can help to enhance prognosis and provide targeted treatment.

Lisa is a licensed physiotherapist and an assistant professor in the School of Rehabilitation Science at McMaster University (Ontario, Canada). Her extensive academic background in physical therapy and clinical epidemiology have shaped her research interests in common age-related musculoskeletal problems. Her most recent studies focus on improving treatment and outcomes for people with musculoskeletal disorders, such as knee osteoarthritis and chronic low back pain. Lisa is interested in understanding the mechanisms and consequences of pain as they relate to disability, mobility, participation, and healthy aging.

RESOURCES

Journal articles

·     Association of Intermittent and Constant Knee Pain Patterns With Knee Pain Severity and With Radiographic Knee Osteoarthritis Duration and Severity

·     Association of Pain Sensitization and Conditioned Pain Modulation to Pain Patterns in Knee Osteoarthritis

·     Use of IMMPACT Recommendations to Explore Pain Phenotypes in People with Knee Osteoarthritis

CONNECT WITH LISA

·     Twitter: @LisaCarlesso

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

Hosted on Acast. See acast.com/privacy for more information.

Having a chronic physical health condition such as osteoarthritis can have a negative effect on mental health which commonly manifests as depression or anxiety. Epidemiological research has shown that most adults with common mental health conditions do not access psychologically-based treatments. This is due to many reasons including costs, stigma, long waiting lists and availability outside of major cities.

Professor Blake Dear joins us to discuss the impact of mental health on the management of osteoarthritis and effective psychological treatments that can help to improve mental health in the long-term.

Professor Blake Dear is a Senior Clinical Psychologist within the Department of Psychology at Macquarie University. Blake completed his postgraduate Masters training at the University of Western Sydney in 2006 and later completed his PhD in 2010. Blake is the Director of the eCentreClinic; a research unit that develops and evaluates a range of psychologically-based treatments for common mental health and chronic physical health conditions. He is passionate about increasing access to effective psychological treatment, particularly for adults struggling with chronic physical health conditions.

RESOURCES

-      eCentreClinic

-      Mindspot

-      PORTS

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

Hosted on Acast. See acast.com/privacy for more information.

On this week’s episode of Joint Action, Prof Rana Hinman joins us to discuss how shoes or insoles can help with knee OA.

People with knee OA may experience abnormal knee joint loading – meaning that certain parts of their knees (for example, the inside or medial compartment) is loaded more, compared to the outside or lateral compartment. Biomechanical research has shown that some shoes can increase medial knee loads more than others and therefore, clinical guidelines commonly recommend “appropriate” footwear for knee OA.  Many types of shoes exist including “stable, supportive shoes”, “flat flexible shoes” and “unloader” shoes. However, it remains unclear what shoes are appropriate for knee OA.

Professor Rana Hinman is a research physiotherapist and National Health & Medical Research Council Senior Research Fellow at the Centre for Health, Exercise & Sports Medicine at the University of Melbourne. Her research focuses on clinical trials of non-drug non-surgical treatment strategies for osteoarthritis, in particular exercise, rehabilitation, and biomechanical interventions.

RESOURCES

Better Health Channel Victoria

• Choosing the right shoe
• Footwear for healthy feet

Journal articles

• The Effect of Flat Flexible Versus Stable Supportive Shoes on Knee Osteoarthritis Symptoms : A Randomized Trial
• Moderators and mediators of effects of unloading shoes on knee pain in people with knee osteoarthritis: an exploratory analysis of the SHARK randomised controlled trial

CONNECT WITH RANA

Twitter: @HinmanRana

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

Hosted on Acast. See acast.com/privacy for more information.

On this episode of Joint Action, we are joined by Dr Jackie Whittaker to discuss osteoarthritis prevention, risk factors and prevention strategies.

Osteoarthritis is the most common joint condition, affecting more than 300 million people worldwide. There is currently no cure for OA and the current management strategies for OA are focussed on alleviating symptoms. Current management and include core treatments such as patient education, exercise and physical activity and weight loss or weight management if necessary. Given that there is no cure for OA, research into the field of osteoarthritis prevention has been emerging, and although there is still work to be done in the field, there has been new insights into modifiable risk factors such as obesity and joint injury.

Dr. Jackie Whittaker is an Associate Professor in the Department of Physical Therapy, at the University of British Columbia and is recognized as a Clinical Specialist in Musculoskeletal Physiotherapy by the Canadian Physiotherapy Association. She completed her BScPT degree at the University of Alberta, PhD in Musculoskeletal Rehabilitation at the University of Southampton (UK) and a post-doctoral fellowship supported by an Alberta Innovates Health Solutions Clinician Fellowship in injury prevention and epidemiology at the University of Calgary. She has been an Assistant Professor in the Department of Physical Therapy and Research Director of the Glen Sather Sports Medicine Clinic at the University of Alberta.

RESOURCES

• A lifespan approach to osteoarthritis prevention

CONNECT WITH JACKIE

Twitter: @jwhittak_physio

CONNECT WITH US

• Twitter: @ProfDavidHunter @jointactionorg
• Email: [email protected]
• Website: www.jointaction.info/podcast

If you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts!

Hosted on Acast. See acast.com/privacy for more information.