Improving life for osteoarthritis sufferers

Almost two million Australians suffer from the debilitating disease osteoarthritis. Clinical rheumatologist Dr Anita Wluka is leading pioneering research into the condition and has two critical outcomes in sight. The first is to identify how to delay the onset of osteoarthritis. The second is to make the disease easier for patients to manage.

Current treatment strategies for the disease rely almost solely on losing weight. 'We're looking to find something to limit the spread of the problem and slow down the pain and joint damage,' Anita says.

Recognised as a world-leader in osteoarthritis research, Anita is based at The Alfred hospital where she combines research with clinical practice as a physician. She is passionate about her research, but says spending time with patients is what really inspires her work.

'My research is strongly influenced by my clinical work, examining the relationship between what is happening in the joint and pain. There are many different patterns of osteoarthritis. For example, everyone has a different joint shape. By defining this we may be able to work out whether lifestyle factors, such as exercise, may be good or bad for your joints.'

She says even a small delay in the progress of the disease when it is first diagnosed would make a significant difference to the wellbeing of patients and to public health costs in terms of joint replacements. 'Only a small reduction in risk across the country would make a big difference to society.'

Understanding osteoarthritis has been a focus of Anita's ground-breaking work since 1999. Her previous research has examined risk factors for osteoarthritis and developed methods for measuring the disease.

Methods used to assess earlier studies on the effects of hormone replacement therapy and obesity on cartilage had proved too difficult to be used consistently. Anita focused on developing and validating measurements of disease severity. This was extended to the use of magnetic resonance imaging to track the progress of the disease.

Anita credits colleague Professor Flavia Cicuttini, head of The Alfred's Rheumatology Unit and the Musculoskeletal unit at Monash University's Department of Epidemiology and Preventative with kick-starting her interest in analysing and measuring arthritis risk factors.

Her work has contributed to guidelines for managing hip and knee osteoarthritis developed through the Royal Australasian College of General Practitioners National Health and Medical Research Council.

In her latest projects, Anita has completed a number of randomised controlled trials supported by the National Health and Medical Research Council. One found that vitamin D does not protect against the progression of knee osteoarthritis. However, further results are pending regarding its effect on other forms of musculoskeletal disease. Another provides promising results for the  role of an antidepressant in back pain.

She has a number of other clinical trials in progress, also supported by the National Health and Medical Research Council. These are investigating the role of novel therapies for knee pain and back pain. The results of some of these will be released in the next two years, with other clinical trials still under recruitment.

Musculoskeletal conditions are a major cause of disability and loss of work nationally and internationally. Improving the understanding of these conditions is essential to improve their management. Any interventions need to be tested in clinical trials. Given the ubiquity of musculoskeletal conditions, and the significant burden they impose on our society, the need for effective, inexpensive treatments are essential to offset their rising costs which threaten to overburden the health care system.  

Osteoarthritis

Musculoskeletal conditions

Back pain

Foot pain

Clinical Trials

Rheumatologist at the Alfred Hospital

Coordinator of MPH 5213 Research Methods