Current approach to the conservative management of arthrosis: results of the "Osteo-Experience" project

BACKGROUND: Arthrosis is now intended as a multifactorial pathology that involves various joints and is caused by different biological functional alterations at the basis of the joints damage. Considering this new evidence, the prevention and the conservative treatment of arthrosis acquire an important role with respect to a surgical approach. The "Osteo-Experience" project was designed to collect, describe and compare the personal experiences of osteoarticular specialists in the field of the conservative treatment of the various forms of arthrosis. In addition, some useful insights for a correct management of conservative therapy in respect to the various forms of arthrosis were provided. METHODS: A group of Italian osteoarticular specialists with experience in the treatment of arthrosis were asked to describe their routine clinical practice regarding their more usual therapeutic schemes. The type of patients normally being treated by the osteoarticular specialists were described. An electronic question-and-answer form was provided. Each form simulates a patient visit, that must be imagined based on the most common personal experience. RESULTS: Seven hundred sixty-five forms were considered. A frequent use of NSAIDs and COX-2 inhibitors emerged, especially for early arthrosis and in older subjects with advanced osteoarthritis. Hyaluronic acid and chondroprotectors are used with great frequency in all types of osteoarthritis. A reduction of pain is reported in all settings of patients. Problems related to the conservative therapies are reported only in a small minority of cases, along with a good degree of satisfaction by doctors and patients. CONCLUSIONS: Observations collected within the "Osteo-Experience" project show that a more conscious use of the conservative therapy should be pursued for arthrosis. The present study denotes how it is necessary to better define some therapeutic schemes based on the different clinical characteristics of the patient, to improve the clinical outcome.