Section I: Setting the Stage   |    
Needs and Opportunities in the Assessment and Treatment of Osteoarthritis of the Knee and Hip: The View of the Rheumatologist
Steven R. Goldring, MD1
1 The Hospital for Special Surgery, Weill College of Medicine of Cornell University, 535 East 70th Street, New York, NY 10021. E-mail address: goldrings@hss.edu
View Disclosures and Other Information
Disclosure: The author did not receive any outside funding or grants in support of his research for or preparation of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the author, or a member of his immediate family, is affiliated or associated.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Feb 01;91(Supplement 1):4-6. doi: 10.2106/JBJS.H.01443
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


Osteoarthritis represents a major therapeutic challenge to medical and health-care providers. In part, this is related to the limited tools that are available for assessing the structural state of joint tissues and to the lack of effective therapies to alter the natural history of osteoarthritis progression. From a clinical and pathologic perspective, osteoarthritis is not a homogeneous disorder, and the underlying pathogenic mechanisms differ among individuals. Even in the same individual, the pathologic processes and etiologic mechanisms may differ at specific stages of disease progression. In the development of strategies for effective intervention, several issues need to be considered. First, the stage of osteoarthritis progression must be considered. Therapies that are effective prior to the development of structural alterations may have limited utility in later stages. Similarly, treatments for late-stage osteoarthritis need to be adapted and adjusted to target specific symptoms that are amenable to modification. Despite the limited therapeutic options available for the treatment of osteoarthritis, there are interventions that have been shown to be beneficial. These include preventive strategies as well as specific interventions, such as the judicious use of analgesic medications for the control of pain. It is essential to develop an integrated multidisciplinary approach to osteoarthritis; this approach should be one that involves medical and surgical specialists as well as other health-care providers. In addition, further clinical and basic-science research is needed so that improved and more effective therapies for osteoarthritis as well as better methods for monitoring and assessing the efficacy of treatment interventions can be developed.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    Ohio - OhioHealth Research and Innovation Institute (OHRI)
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    Georgia - Choice Care Occupational Medicine & Orthopaedics