The Joint Approach Project

The Agency for Clinical Innovation (ACI) has provided funding for the enhancement of a conservative or non-surgical management opportunities for clients with hip and knee osteoarthritis in the Tweed region for a period of 12 months.

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Why is this important?

Osteoarthritis is the most common form of arthritis, and one of the leading causes of pain and disability worldwide. The most commonly affected peripheral joints are the knees, hips and small hand joints. Pain, reduced function and effects on a person's ability to carry out their day-to-day activities can be important consequences of osteoarthritis.1

Osteoarthritis is not an inevitable part of ageing and not necessarily progressive. Symptoms can be managed and the level of physical activity improved by the modification of risk factors. Current guidelines recommend a combination of non-pharmacological and pharmacological management as the core treatment for osteoarthritis at all stages of the disease. This core treatment includes patient education and self-management, exercise, weight loss for those who are overweight, joint protection and medicines. Timely access to knee replacement or joint conserving surgery is recommended when, and only when, core treatment no longer provides adequate pain relief or maintenance of function.2

Case for change in the Tweed area:

  • 280 clients on Tweed Public waitlist for TJR surgery. Over 70% have not had any conservative management
  • 28% population aged over 60yrs and predicted high population growth

This project will work with an integrated health methodology to:

  • Improve services for people with knee and hip osteoarthritis OA
  • Reduce burden of disease costs through timely assessment and management of OA
  • Optimise clients OA journey (with or without joint surgery)


The Ideal patient journey:


1National Institute for Health and Care Excellence: Osteoarthritis: care and management Clinical guideline (2014)

2Australian Commission on Safety and Quality Health Care Standards - Osteoarthritis of Knee clinical care standards V3.4 (2016)