An ageing population means osteoarthritis is becoming increasingly common, so School of Physiotherapy researchers want to see if physiotherapy can not only decrease pain and disability, but also reduce the need for hip or knee-joint replacement surgery.

Dr Haxby Abbott, a senior research fellow in clinical research, and his team have been awarded two Health Research Council grants worth around $800,000 to see how effective - and cost-effective - physiotherapy can be for people with osteoarthritis.

They will compare several different approaches: manual therapy (in which the joints are manipulated and stretched), exercise therapy (using an exercise programme) and a mixture of the two approaches.

"We want to see what proportion of patients benefits and to what degree," he says.

The Dunedin study will also analyse the potential economic benefits in the New Zealand situation.

Abbott says a similar US study found that, after one year, one in seven patients had either delayed or put off their surgery. A course of physiotherapy costs about $540 compared with $16,000 for joint replacement.

"Calculating from the numbers in that US study, taking this approach here could save over $16 million per year. There is also the potential to produce savings in the cost of specialists, medications, adverse events and hospital time," he says.

"Even if only one in 30 patients treated with physiotherapy was able to delay or prevent joint replacement it would be worthwhile for the health system. At the same time, a much larger proportion would enjoy less pain and disability."


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