Health experts and patients partner to tackle osteoarthritis

(Edmonton) Jean Miller isn't sure how long she's had osteoarthritis in her knee.

Despite a lengthy career in nursing specializing in gerontology, Miller can only guess that she's had the degenerative joint disease for about five years. Like so many Canadians, she experienced symptoms years before getting an actual diagnosis.

"Who knows?" Miller says on how long she's lived with osteoarthritis. "As things change in your body, the pain is very gradual, and often people-and sometime doctors, too-will assume it's part of getting older. But by then, it's too late for early intervention."

That's an experience scientists hope to change through novel research, clinical care, patient education and prevention. Osteoarthritis affects one in eight adult Canadians now and will affect one in four within the next generation.

Osteoarthritis is more common in older adults-a fact that has serious implications for Alberta's health-care system as the population ages, says Linda Woodhouse, the David Magee Endowed Chair in Musculoskeletal Clinical Research in the Faculty of Rehabilitation Medicine at the University of Alberta.

Osteoarthritis can develop due to genetics, injury, poor biomechanics and obesity, Woodhouse says.

"People aren't aware that when we start to lay down weight in middle age, the amount of fat we carry on our trunk, in our bones and muscles, in and of itself can cause osteoarthritis. The worst thing we can do is sit down and become inactive."

Wood Forum brings together patients and osteoarthritis experts

Early intervention requires educating patients about osteoarthritis, which is a driving force behind the Wood Forum on Oct. 24 at Corbett Hall on the U of A's north campus.

An initiative of the McCaig Institute for Bone and Joint Health and supported by the Wood Foundation and a Canadian Institutes of Health Research grant, this free event gives the public direct access to talk to osteoarthritis researchers and clinicians about hip and knee issues, including the causes, consequences and prevention of joint injuries.

Woodhouse, who is also scientific director of the Bone and Joint Health Strategic Clinical Network with Alberta Health Services, is bringing together musculoskeletal expertise from across the province, including the Alberta Osteoarthritis Team, funded by Alberta Innovates - Health Solutions, to find new ways of improving research and health care and educating patients. A similar event was held Sept. 19 in Calgary.

Education has never been more critical, given a 73 per cent spike in hip and knee replacement surgeries due to osteoarthritis in Alberta, Woodhouse says. This upswing is driven by improvements to the system and younger patients in their forties and fifties-many of them "weekend warriors" and physically active-turning to surgery as an option to maintain their level of activity, she says.

Despite this upswing in demand, length of stays in hospital have decreased to an average of four days. Acute care bed days have gone up just five per cent as Alberta scientists-including teams from the U of A-advance research and care, Woodhouse says. They're breaking new ground exploring the benefits of everything from early diagnosis and using stem cells to grow new cartilage to prehabilitation before surgery.

"We're trying to move upstream and say, 'Can we identify people early on that have osteoarthritis and intervene with different therapeutic strategies,' so you don't end up having severe osteoarthritis and needing joint replacement at all," Woodhouse says.

The forum also helps patients, such as Miller, learn from one another. The retired nurse and nursing instructor from Calgary will talk about her involvement with the bone and joint clinical network and her work with other patients to learn about their experiences and changes they'd like to see in the system.

"Raising the profile of osteoarthritis is very important, not just for the cost to the health-care system, but to make people aware of what it is and what their options are," Miller said. "I may need surgery down the road or I may not, but in the meantime I need to know how to manage it. That's where the system needs to focus, and that's why collaboration is so important."

Wood Forum information and registration