Publication:

Clinical practice trends and therapeutic preferences in osteoarthritis management: a cross-sectional survey of orthopaedic surgeons in India

Background Osteoarthritis (OA) is a leading cause of disability worldwide and presents a growing challenge, particularly in India’s aging population. Despite its burden, there is a limited data exist on how OA is managed in real-world clinical settings across India. This study assessed the prescribing patterns and therapeutic preferences of orthopaedic surgeons in India, focusing on pharmacological interventions, intra-articular therapies, and the utilization of adjunctive treatments such as collagen and nutritional supplements.

Methods A total of 250 orthopaedic surgeons across India participated in this cross-sectional survey carried out by the Indian Orthopaedic Rheumatology Association (IORA). The 32-item questionnaire created by orthopaedic surgeons explored clinical observations, treatment preferences, comorbidity challenges, and attitudes toward nutraceutical use in OA management.

Results Most clinicians reported a high OA burden in their practice, with symptom onset frequently observed as early as 30–45 years. Obesity and poor nutritional status were identified as common complicating factors. Lifestyle modification was the preferred initial approach, followed by acetaminophen as the first-line pharmacologic agent, especially in elderly patients or those with comorbidities. Topical NSAIDs were favoured for their efficacy and safety profile. A growing role for undenatured collagen type II (UC-II, Lonza) was evident, with 55.2% of respondents prescribing it routinely, particularly in mild-to-moderate OA. Over 75% supported its early initiation, and nearly half considered it for preventive use in high-risk individuals.

Conclusions Indian orthopaedic surgeons are increasingly adopting a holistic, multimodal approach for osteoarthritis management, balancing early intervention with safety. The growing use of UC-II and nutritional supplements highlights a preventive shift in clinical practice.