Alternatives to the knife for OA

3 minute read

Professor Kim Bennell and Associate Professor Kade Paterson discuss non-drug and non-surgery options that work for osteoarthritis patients.

When the choice is between writing a script for pain killers and a 45-minute consultation about weight management, which one do you choose? 

Associate Professor Kade Paterson, University of Melbourne, is a guest in this episode of In Conversation podcast. He says scripts for pain killers and referrals to orthopaedic surgeons are unnecessarily common for patients with osteoarthritis (OA).  

Professor Paterson says everyone who has osteoarthritis should be offered some sort of therapeutic exercise that suits them, and his fitness focus is backed by evidence. 

“We see very positive outcomes from the three approaches – exercise, weight management and education. All have been shown to be clinically effective at reducing both pain and function,” Professor Paterson says. 

Professor Kim Bennell is director of the Centre for Health, Exercise and Sports Medicine at University of Melbourne. She also joins the In Conversation podcast and says that the kind of language clinicians use with osteoarthritis patients is important. Focusing on the person, rather than the joint, is shown to be clinically effective in improving a patient’s willingness to take up exercise, she says. 

“Using language that talks with optimism about the effective, different treatments out there,” is a small change that is relatively easy to make, says Professor Bennell. 

“We also know that positive expectation of benefit is a predictor of outcome as well. So, if you believe that a treatment is going be effective, you’re much more likely to have better outcomes from that treatment,” she said 

Dr David King also advocates for non-drug and non-surgical treatments to be prescribed first. He’s on the project team for the Handbook of Non-Drug Interventions (HANDI)

“HANDI is designed to be a similar resource as a pharmacopeia for drugs – just like when we look up, say Australian Medicine Handbook, we can get an idea of the indication and the dose of the non-drug intervention and any contraindications and size of benefits,” he said. 

This episode also delves into the latest research into foot OA, when ACL surgery is best, why young girls are at risk and what gets in the way of a doctor trying non-drug treatments first. 


OA treatment resources from the Centre for Health, Exercise and Sports Medicine. 

Handbook of Non-drug Interventions (HANDI) 

You can listen and subscribe to the show by searching for “Rheumatology Republic In Conversation” in your favourite podcast player.  

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