https://www.mqhealth.org.au/services/find-a-service/orthopaedic-services
This multidisciplinary conference addressed the contemporary management of arthritis, emphasizing practical strategies for Australian clinicians. **Associate Professor Frederick Joshua** detailed the assessment of inflammatory polyarthropathies, including rheumatoid arthritis, psoriatic arthritis, and lupus, highlighting the importance of clinical criteria, serological markers (rheumatoid factor, CCP antibody, ANA), and imaging like ultrasound. Early initiation of **DMARDs (e.g., methotrexate)** and biologics was discussed, along with essential pre-screening.

**Dr. Matthew White** focused on hand and wrist osteoarthritis, particularly DIP and thumb CMC joint arthritis, stressing that treatment should be guided by symptoms and function, not solely radiographs. Surgical options for DIP (fusion) and CMC (trapeziectomy, joint replacement) arthritis were presented. **Mr. Jonathan Kuan** outlined the role of hand therapy, including orthoses and joint protection strategies, in managing hand arthritis.

**Professor Sam Adie** and **Dr. Mustafa Alttahir** addressed hip and knee arthritis in younger patients, respectively. Professor Adie discussed the aetiology (e.g., FAI, AVN), assessment using the Oxford hip score, and prioritised non-surgical management (education, exercise, weight loss). Surgical options, including hip arthroscopy (limited role in established arthritis) and joint replacement, were discussed based on pain and functional impact. Dr. Alttahir highlighted the importance of **lower limb alignment** in knee osteoarthritis and presented joint-preserving surgical options like high tibial and distal femoral osteotomies for varus and valgus malalignment, respectively.

**Associate Professor Mark Haber** discussed the unique aspects of shoulder arthritis, often associated with rotator cuff tears (cuff tear arthropathy). The limited role of physiotherapy in isolation was noted, with **cortisone injections (ideally ultrasound-guided)** playing a significant role in non-operative management. **Reverse shoulder replacement** was highlighted as a successful intervention for cuff tear arthropathy. **Miss Bridget Dean** presented evidence-based physiotherapy programs like GLAD and PEAK for managing large joint osteoarthritis (hip and knee), emphasising education and exercise.

Panel discussions covered analgesic ladders, the timing of ceasing and restarting DMARDs/biologics around surgery (generally a week post-operatively), and considerations for persistent pain following total knee replacement. Health fund arrangements facilitating no-gap joint replacement surgery were also discussed. The conference underscored the value of a multidisciplinary approach and early intervention to optimise outcomes for patients with arthritis in the Australian healthcare context.