Knee osteoarthritis care

Associate Professor Christian Barton’s research is transforming knee osteoarthritis care in Australia

Associate Professor Christian Barton’s research is transforming knee osteoarthritis care in Australia by improving access, adoption and adherence to first-line interventions.

Knee osteoarthritis affects a staggering 2.2 million Australians, imposing a lifelong burden characterised by symptoms of significant pain and stiffness. Those with knee osteoarthritis are also more likely to have poorer quality of life and are at risk of developing obesity, heart disease and depression.

“Adding to the severity of the situation, the escalating healthcare costs associated with knee osteoarthritis are reaching unsustainable levels due to knee replacement surgeries surpassing 60,000 procedures annually,” says Associate Professor Barton.

“While knee replacement surgery can be effective for the right candidate, one in five surgeries fail to provide a meaningful reduction in pain and one in eleven surgeries result in adverse events, such as blood clots.”

Current knee osteoarthritis guidelines say patient education, exercise therapy and weight management (where indicated) are the gold standard interventions before considering surgical options.

“These interventions are cost-effective and reduce the need for surgery. However, 57% of Australians with knee osteoarthritis do not receive this low cost and safe care,” says Associate Professor Barton.

“Access to appropriate care is particularly problematic for people who can't access private healthcare, or those who are from culturally and linguistically diverse backgrounds as there is an absence of programs and services adapted to meet their needs.”

Associate Professor Barton’s research has been instrumental in identifying the modifiable barriers which have impeded the provision of guideline-based care for knee osteoarthritis in Australia.

“Through several mixed-methods studies involving people with osteoarthritis and health professionals, the key barriers I have identified include inaccurate patient and clinician beliefs (for example, “exercise is dangerous”), inconsistent access to programs and services, and lack of confidence and competence in the workforce to provide guideline-based care,” he says.

Associate Professor Barton’s research led to the adaptation and implementation of the ‘Good Life for osteoArthritis from Denmark’ (GLA:D) program in Australia.

“GLA:D is a group-based education and exercise program developed by researchers in Denmark for people with hip or knee osteoarthritis, and we have adapted it for use in Australia,” he explains.

“Since its implementation in 2017, GLA:D Australia has helped 659 public and private health services across all states and territories provide guideline-based care for their communities. Also, through a 2-day workshop, GLA:D Australia has trained 14,462 musculoskeletal physiotherapists in providing education and exercise therapy.”

Through his work, Associate Professor Barton has made a meaningful contribution to improving knee osteoarthritis care but hopes to continue expanding these efforts and has his sight set on new objectives.

“One such objective is to understand the impact of limited English-language proficiency on knee osteoarthritis outcomes, co-design interventions, and improve equity of access to guideline-based first-line care in the CALD population.”