The Grand Challenge – Managing End-Staged Joint Osteoarthritis

WHAT IS THE PROBLEM? Musculoskeletal disease is a common condition that affects up to one-quarter of the population over 65 years in many developed countries. Over 6 million Australians (1) and 27 million Americans (2) are affected by some type of musculoskeletal disorder of which osteoarthritis (OA) is the most common. Musculoskeletal disorders account for one-fifth of all consultations with general practitioners (3) in Australia. The total treatment cost of OA and other musculoskeletal conditions in Australia was estimated as $55.1 billion in 2012, and the burden of disease cost was estimated to be $34.2 billion, based on a loss of 182,135 disability adjusted life years (DALYs) (4). In the United States, the personal and community cost of musculoskeletal diseases including those through lost wages now approaches $950 billion (5). The 2010 Global Burden of Disease Study demonstrates the worldwide scale of this problem, identifying musculoskeletal disorders as the second largest contributor to life lost through disability after Cancer (6). OA has the highest trajectory of increasing prevalence across all musculoskeletal conditions (4) and in Australia is forecast to become the leading cause of disability (7). Total joint replacement (TJR), which is not only effective for improving the quality of life of people with end-stage OA (8), is also a cost-effective solution (9).