[Physio Discussed] Alternative perspectives on osteoarthritis management with Prof. Ian Harris and Prof. Jeffrey Katz

Osteoarthritis management requires shifting from a purely structural, "wear and tear" model to one that prioritizes mechanical load, inflammation, and patient-centered behavioral change. Radiographic imaging frequently fails to correlate with pain levels, as joint damage often appears severe while symptoms remain mild, or vice versa. Consequently, clinical assessment must focus on identifying the true drivers of pain, such as spinal radiculopathy or bursitis, rather than defaulting to surgery. Exercise, weight management, and education serve as the primary evidence-based interventions, yet their effectiveness is often limited by behavioral barriers. While joint replacement remains a highly successful procedure for severe cases, it is most effective when patient expectations are aligned with realistic functional outcomes and when surgery is reserved for cases where conservative management has failed to address the specific source of pathology.