(Multidisciplinary) guidelines

The ultimate treatment for osteoarthritis of a joint is often a joint replacement prosthesis. However, a prosthesis has a limited shelf life. In younger patients (<70 years) the chance of a new operation after a knee arthroplasty is (5% within 10 years). This chance increases as a patient is younger and moves more. In addition, 17-20% of patients continue to have complaints after a knee orthosis. Therefore, in patients with mild osteoarthritis or patients younger than 70 years, it is preferable to postpone surgery as long as possible.

Multidisciplinary conservative treatment

Most national and international guidelines for the treatment of osteoarthritis recommend starting with conservative (non-operative) treatment before proceeding with surgery. With the right approach, surgery can in many cases be prevented or postponed for several years. In practice, these non-operative treatment options are insufficiently utilized (Hofstede 2015; Smink 2013). For example, 81% of patients with osteoarthritis of the knee or hip who come to the orthopedic surgeon have not yet tried all non-operative treatments (Snijders 2011) and in only 10% of cases a patient is offered these.

WHY NOT OPERATE (yet)?

An important reason for patients to opt for non-surgical treatment is that they would like to continue to exercise. Patients more often opt for a conservative treatment plan if there is good guidance from a physiotherapist and if sufficient time is taken for information about the treatments they will receive. The feeling of being taken seriously and good cooperation between the various practitioners are also important conditions for following a conservative treatment trajectory. The main reason that patients opt for surgery is if their treating physician has a preference for surgical treatment. Even if patients have a lot of cartilage loss (bone on bone) or if they know someone who has had a good experience with surgery, they are more likely to opt for surgical treatment (Hofstede 2016).

Best result

Patients are more likely to try physiotherapy, lifestyle advice and nutritional counseling if they have a good relationship with their treating physician, and if the physician takes sufficient time to explain everything properly. Good information and attention to the patient also help to increase confidence in the treatment, and greater confidence in the treatment leads to a better result than when there is little confidence in the treatment (Benedetti 2007, from Doherty and Dieppe, 2009).

Why Multidisciplinary?

There are many different causes for osteoarthritis and the treatment also has many different aspects. That is why other practitioners are involved in osteoarthritis in addition to your treating physician. These are, for example, a physiotherapist, a dietician or podiatrist. A multidisciplinary approach means that a patient is supervised by at least two different healthcare providers, from at least two different disciplines. The aim of this is to provide the best possible care, guidance and support to every patient.

artroseklinieken

Uw behandeling bij artroseklinieken

At ArtroseKlinieken we work according to the ‘Stepped Care’ principle. Information and education, exercise advice, nutritional advice and weight control form the core of the approach. If the effect is insufficient, other treatments are used, including supervised remedial therapy, a brace or arch supports, guidance from a dietitian, and various types of injections.

We start with treatments that are easily accessible to you as a patient and where you are in control. It is important that the treatment is not too stressful and that you run little risk of side effects or aggravation of your complaints. We look at your wishes and possibilities and, based on your personal situation, we draw up a tailor-made treatment plan.

Step 1: The appointment

For information or to make an appointment, please contact us by phone or email. You need a referral from your general practitioner or medical specialist to make an appointment with one of our doctors. As soon as we have received the referral letter, we will contact you to schedule the appointment. We ask that you bring as much information from your medical history as possible. If necessary, we can also request this from your general practitioner or medical specialist.

Step 2: Intake by a sportsdoctor

The process starts with an intake with one of our sports doctors. The doctor asks you about your complaints and medical history, performs a physical examination and examines which factors play a role in your complaints. Think about the position, strength, stability and function of your joints. Our doctors themselves assess the available examinations (X-ray, MRI scan) and request a new examination if necessary.

Step 3: The multidisciplinary treatment plan

After making the diagnosis, your doctor will draw up a personal treatment plan with you.

If you have severe osteoarthritis, you may be referred to an orthopedic surgeon. However, most people with osteoarthritis do not require surgery and a wide range of conservative treatments are available. Our doctors look at which treatment suits you best and how your complaints can best be tackled. In many cases, other multidisciplinary disciplines can also be involved, such as the physiotherapist, dietician or podiatrist.

Would you like to know which treatments we offer? Then click here.

Step 4: Follow up

Because we would like to know whether the treatment that has been initiated is working and whether your complaints are improving, a follow-up appointment will take place with your doctor after 6 to 8 weeks. We map out your complaints with the help of a score list and the doctor evaluates with you or on the basis of your complaints and your activity pattern where there is room for improvement