Reducing pain caused by knee osteoarthritis through diet and exercise

Osteoarthritis is a painful condition caused by joint dysfunction, affecting cartilage as well as other tissues within the joints. It affects more than 2.2 million people in Australia, with knees being one of the more commonly affected areas. People who are overweight or obese can experience more pain due to the increased weight being placed on the affected joints, making movement more challenging.

Joint replacement surgery is a common course of action taken to reduce this pain. However, osteoarthritis costs the Australian healthcare system more than $3.5 billion per year, with joint replacement surgery being one of the key drivers of these costs. It is estimated that avoiding or delaying this expensive procedure could reduce healthcare costs by $233 million each year by 2030.

Dr Belinda Lawford, Professor Rana Hinman, Professor Kim Bennell, Dr Thorlene Egerton, Alex Kimp, and Libby Spears from the Centre for Health, Exercise and Sports Medicine at the University of Melbourne developed two non-surgical telehealth interventions to reduce pain associated with knee osteoarthritis, focusing on diet and exercise.

Developing the solution

In a clinical trial led by the University of Melbourne and conducted jointly with Austin Health, Monash University, and private health insurer Medibank, participants with painful knee osteoarthritis underwent one of three programs; an exercise intervention, a diet and exercise intervention, or no intervention at all.

Those in the combined exercise and diet program reported a greater reduction in knee pain, lower use of pain medications, and an average weight loss of 10 kilograms. Importantly, after both the exercise-only and diet and exercise programs, between 55 to 70 per cent of people were unwilling to undergo knee joint replacement surgery in the future.

A qualitative follow-up study also found that participants valued that the program was delivered entirely via telehealth, finding it to be convenient while also not affecting their rapport with their physiotherapist or dietician.

Following the results of the clinical trial, Medibank started permanently offering the diet and exercise program to eligible members with knee osteoarthritis in April 2021. Since scaling up, hundreds of patients have undergone the program reporting high levels of satisfaction with their care.

Importantly, with the program being offered online via telehealth, patients can participate in the program and reduce their pain from anywhere in Australia including rural and remote locations. Participants receive support for one year, ensuring that lifestyle changes resulting from the program become firmly embedded and continue after the initial weight loss period.

The project is also supporting a more enduring partnership with Medibank, with the project team soon to trial a similar diet and exercise program to help relieve pain associated with hip osteoarthritis. This trial is currently under recruitment with Medibank members being eligible to participate.

Partners

• Dr Belinda Lawford, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences.
• Professor Kim Bennell, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences.
• Professor Rana Hinman, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences.
• Dr Thorlene Egerton, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences.
• Alex Kimp, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences.
• Libby Spiers, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences.