A groundbreaking study led by Monash University has revealed that structured education and exercise therapy could serve as cost-effective alternatives to knee replacement surgery for individuals with lower pain levels. This approach not only helps improve patient outcomes but also enhances the sustainability of the healthcare system.

Knee replacement surgery is often recommended for people suffering from knee osteoarthritis, significantly alleviating pain and enhancing quality of life. However, concerns have arisen regarding the overuse of this procedure beyond the recommended guidelines.

The research team, spearheaded by Dr. Sean Docking from the School of Public Health and Preventive Medicine at Monash University, examined the costs and health outcomes of a national physiotherapy program compared to knee replacements. Their analysis utilised Australian clinical registry data and published trial results to draw their conclusions.

The study focused on GLA:D Australia, a structured education and exercise program that equips participants with self-management skills for their osteoarthritis. Co-author Associate Professor Christian Barton leads this implementation project from La Trobe University.

Dr. Docking highlighted a significant barrier to the uptake of physiotherapy programs.

"Unlike joint replacement surgery, physiotherapy-led programs are rarely subsidised by the government. Even with private health insurance, accessing these programs can incur costs that deter individuals from pursuing them before considering surgery."

The findings, published in JAMA Network Open, indicate that the Australian healthcare system could potentially save $100 million annually by delaying or avoiding knee replacements in patients with lower pain levels. The study demonstrated that structured education and exercise therapy are cost-effective for the first nine years and over the lifetime of individuals experiencing low pain.

"Our results emphasise the necessity for carefully considered approaches that enhance care sustainability and ensure the right patient receives the right care at the right time," Dr. Docking stated.

Additionally, minimising unnecessary joint replacements could alleviate the strain on the Australian healthcare system. Currently, around 30% of public patients wait over a year for knee replacement surgery.

Co-author Professor Ian Harris from UNSW Sydney pointed out that one in four knee replacement surgeries in Australia may be unwarranted. He noted that these procedures consume a substantial portion of the healthcare budget.

"Funding physiotherapy-led programs would align with the government’s best practice recommendations and enhance care quality for knee pain. It could generate significant cost savings by avoiding unnecessary surgeries and ensuring timely access for those who genuinely require surgery," Professor Harris concluded.

This research underscores the importance of integrating effective physiotherapy programs into standard care pathways, paving the way for improved patient outcomes and a more sustainable healthcare system.