Knee pain and osteoarthritis in older adults: a review of community burdenand current use of primary health care

Background-Osteoarthritis is the single most common cause of disability in older adults, and most patients with the condition will be managed in the c ommunity and primary care. Aim-To discuss case definition of knee osteoarthritis for primary care and to summarise the burden of the condition in the community and related use o f primary health care in the United Kingdom. Design-Narrative review. Method-A literature search identified studies of incidence and prevalence o f knee pain, disability, and radiographic osteoarthritis in the general pop ulation, and data related to primary care consultations, Findings from UK s tudies were summarised with reference to European and international studies . Results-During a one year period 25% of people over 55 years have a persist ent episode of knee pain, of whom about one in six in the UK and the Nether lands consult their general practitioner about it in the same time period. The prevalence of painful disabling knee osteoarthritis in people over 55 y ears is 10%, of whom one quarter are severely disabled. Conclusion-Knee osteoarthritis sufficiently severe to consider joint replac ement represents a minority of all knee pain and disability suffered by old er people. Healthcare provision in primary care needs to focus on this broa der group to impact on community levels of pain and disability.