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J Knee Surg 2023; 36(14): 1392-1398
DOI: 10.1055/s-0043-1768966
Special Focus Section

Integrated Care for Comprehensive Management of Patients with Osteoarthritis: Program Development and Implementation

Kylee Rucinski 
1   Department of Orthopedic Surgery, Missouri Orthopedic Institute, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopedics, University of Missouri System, Columbia, Missouri
,
Cory R. Crecelius
1   Department of Orthopedic Surgery, Missouri Orthopedic Institute, University of Missouri, Columbia, Missouri
,
Renée Stucky
1   Department of Orthopedic Surgery, Missouri Orthopedic Institute, University of Missouri, Columbia, Missouri
,
James P. Stannard 
1   Department of Orthopedic Surgery, Missouri Orthopedic Institute, University of Missouri, Columbia, Missouri
,
James L. Cook
1   Department of Orthopedic Surgery, Missouri Orthopedic Institute, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopedics, University of Missouri System, Columbia, Missouri
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Abstract

Treatment of symptomatic osteoarthritis (OA) is often complicated by comorbidities, which put patients at potentially higher risks following operative interventions. Management of these comorbidities is usually separate from orthopaedic care, with patients invited to return to their orthopaedic surgeon once surgical risk factors are better controlled. However, this practice can lead to disjointed care, resulting in uncertainty, mistrust, unmanaged pain, and dissatisfaction for patients. Integrated care teams provide an effective option for coordinated comprehensive nonoperative and preoperative management of patients with knee OA and medical comorbidities. The objective of this article is to summarize the process for implementation of an integrated program to manage patients with symptomatic knee OA and the initial outcomes at our institution as an example of the effects of integrated patient management in orthopaedics. At the author's institution, an integrated program was implemented, successfully addressing the unmet need for coordinated care for patients with bone and joint health problems and medical comorbidities. Patients who completed the full program experienced significant improvements in both pain and function. Potential applications for knee surgeons considering implementing integrated care models could include pre- and postoperative management programs, nonoperative management program, and programs seeking to meet key metrics such as improved readmission rates, patient satisfaction, or value-based care. For effective program implementation, careful planning with convenient referral mechanisms, leadership buy-in, and patient-centered communication protocols are required.

Keywords

osteoarthritis - integrated care - knee - pain - exercise - therapy


Publikationsverlauf

Eingereicht: 22. Dezember 2022

Angenommen: 15. April 2023

Artikel online veröffentlicht:
23. Mai 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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