Treatment of osteoarthritis of the hip or knee before surgery a stepped-care strategy

Published in BMC Family Practice, 03/13/2013 Dr. Smink and team from Department of Rheumatology, Orthopaedics, Rehabilitation Medicine and General practice of the Sint Maartenskliniek, University Netherlands discuss a  SCS = stepped care strategy for Osteoarthritis (OA) patients prior to total knee and total hip surgery.
Osteoarthritis (OA) of the hip or knee is a common joint disorder leading to pain and functional impairment. Pharmacological and non-pharmacological treatment modalities are the core treatment for OA including physical therapy. In Holland, patients with OA are treated in general practice for approximately 82 months before they are referred to an orthopaedic department.
The group developed a set of clinical practice guidelines (CPGs) to manage hip or knee OA known as the based stepped-care strategy and BART, i.e. Beating Osteoarthritis, to improve the management of hip or knee OA . SCS includes physical therapy as well as (TENS), hyaluronic acid, and glucocorticoid injection and other pain killers together with lifestyle advice.
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