# Strategies to Implement Knee Osteoarthritis Guidelines in Switzerland

## TL;DR

This paper discusses strategies to improve the management of knee osteoarthritis in Switzerland by aligning care with international guidelines.

## Contribution

The paper proposes a national Model of Care and strategies for coordinated, patient-centered KOA management in Switzerland.

## Key findings

- Switzerland has high knee replacement rates, suggesting potential overuse and an evidence–performance gap.
- Stakeholder dialogue identified challenges like inconsistent patient pathways and non-evidence-based treatment sequencing.
- Proposed strategies include a national Model of Care, patient education, and shared decision-making.

## Abstract

Knee osteoarthritis (KOA) is a common chronic disease in Switzerland, associated with high socioeconomic costs and increasing prevalence due to aging and other risk factors. International guidelines recommend a stepped approach focusing on exercise, education, and weight management; however, implementation remains inconsistent. Switzerland has one of the highest knee replacement rates among OECD countries, suggesting potential overuse and indicating an evidence–performance gap in KOA management.

Current efforts promote coordinated, patient-centered care. A repeated stakeholder dialogue in 2024 with representatives of medical and physiotherapy associations, patient organizations, health insurers, and researchers identified challenges: variation in patient pathways across providers; non-evidence-based treatment sequencing with premature escalation to specialist care; and misalignment of expectations between patients and providers.

Proposed strategies include: (1) establishing a national Model of Care based on a consensus treatment framework; (2) strengthening patient health literacy through targeted education; and (3) facilitating patient navigation through effective communication and shared decision-making.

Closing the evidence–performance gap requires collaboration among healthcare providers to improve outcomes, reduce inappropriate care, and support coordinated patient-centered KOA management in Switzerland.