The NORTH Foundation (formerly Kolling Foundation) raises funds to help provide support for urgently needed equipment, patient care services, capital works and essential medical research at Royal North Shore, Ryde and Hornsby Ku-ring-gai Hospitals, as well as the Kolling Institute of Medical Research.
Osteoarthritis (OA) is the most common joint disease in Australia. Despite the tremendous burden this disease places on individuals, the healthcare system and society, more than 30,000 people are offered low-value options such as unnecessary imaging, referral to surgeons and arthroscopic knee procedures (or key-hole surgeries) at an average cost of $5,000. OA costs to the health system are amounting to $150Mio. per year. This concern was highlighted in the National Osteoarthritis Strategy 2018 as a problem needing to be addressed, but rates of surgery are declining very slowly. Clinical practice guidelines recommend education for self-management, exercise, and weight control as first-line care. However, 2 in 3 Australians living with OA do not receive this care.
The DON’T SCOPE FOR OA Project, led by Professor David Hunter and Dr Jillian Eyles, aims to raise orthopaedic surgeons’ and relevant health practitioners’ awareness and use of non-surgical treatment options, saving patients intervening operations as well as reducing hospital and health care costs.
Since its inception in 2022 this project experienced several unexpected challenges leading to further communication with clinicians in the area where knee arthroscopies are the highest, to find out why they are resistant to change. In May 2025 a forum was held for influential surgeons, physicians, researchers, professional organisation representatives, policy makers and health insurers. Participants, key stakeholders in musculoskeletal (MSK) surgery, were asked to contribute to the co-design of a new framework to support the effective translation of knowledge into MSK surgical practice and policy (including for knee arthroscopy). A survey, interviews and discussions during the forum event provided valuable insights into why surgeons continue to perform knee arthroscopic procedures in people with knee osteoarthritis, despite clear recommendations not to do so.
Also, following a recommendation from the Medical Research Future Fund (MRFF), the study team was revised to involve experts in qualitative research, co-design and working with culturally and linguistically diverse (CALD) populations and how these might impact the strategies used in the trial. The revised version of this project is improved because in addition to new strategies the team has been able to leverage several important knowledge translation tools, educational materials and digitally delivered osteoarthritis management support tools that have been developed and evaluated recently.
Our 3-year financial support of this project concluded in 2024. However, the project is ongoing.