On Thursday September 19th, the 2019 Cy Frank Legacy Lectureship stopped in London. The series, spearheaded by the McCaig Institue in Calgary, was created to honour and commemorate Dr. Cyril Frank, an internationally acclaimed champion of multidisciplinary clinical research and care.
Dr. Stefan Lohmander presented in London to 80 attendees regarding his experiences and perspectives on the future of osteoarthritis care. This 2019 tour included talks in Calgary, Edmonton, Toronto, London and Ottawa.
Dr. Lohmander's slides and a recording of his Calgary lecture can be viewed here.
More than 4 million Canadians suffer from osteoarthritis and 2 out 3 are women. Every second person with OA has moderate or severe pain. OA causes more functional limitation and disability than any other chronic disease among the elderly. But OA often begins already in the young and middle-aged, following from joint injury or obesity. OA is not “just” OA: OA is associated with an increased risk for heart disease, diabetes, depression and death.
Prevalence of OA is increasing, and with it the demand for joint replacement surgery. Each day of the working week, 500 knees or hips are replaced in Canada, with a 17% increase over the past 5 years. Projections of a future increase, greying and fattening of Canadian population with ensuing increase of OA question the sustainability of our current management mode for OA. We need to disinvest in low-value care and strive to get it right first time.
The 3 pillars of OA management are education-exercise-weightloss, drugs and aids, and surgery. There is an increasing emphasis on the first pillar, being effective also against the common co-morbidities. Many commonly used OA treatments are low-value or even dangerous, arthroscopic surgery and opioids are glaring examples. Finally, our inability to slow or stop OA disease progression speaks strongly for an increased attention to prevention of OA. Our management of OA is far too often reactive. We need to become proactive.