Quality Standard Details
Osteoarthritis: Care for Adults With Osteoarthritis of the Knee, Hip, Hand, or Shoulder
- Publication Date
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2024-November-01
- Status
- Published
- Topic Area
- Bones, Joints and Muscles
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Osteoarthritis, the most common type of arthritis, is a progressive condition that can affect any moveable joint of the body but most commonly the hips, knees, hands, and shoulders. Studies in various populations show that about 20% to 30% of adults have osteoarthritis in at least one of these joints. The prevalence of osteoarthritis among people aged 20 years and older in Ontario is approximately 14%, and it is expected to increase as the population of older adults grows.
The rising rates of osteoarthritis will have a substantial impact on the lives of people living with the condition and on their families, on costs to the health care system, and on the broader economy through lost productivity, people leaving the workforce, and long-term disability. Despite the known personal and societal burden of osteoarthritis, it is underdiagnosed and undertreated, resulting in missed opportunities for people to benefit from high-quality care.
This quality standard addresses care for adults (18 years of age or older) with osteoarthritis of the knee, hip, hand, or shoulder. The quality standard focuses on the assessment, diagnosis, and management of osteoarthritis for people across all health care settings and clinicians. It provides guidance on nonpharmacological and pharmacological care. It covers referral for consideration of joint surgery but does not address specific surgical procedures. This quality standard does not apply to care for people with osteoarthritis affecting the spine, other peripheral joints (i.e., elbow, wrist, foot, ankle), or neck or low back pain. Similarly, this quality standard also excludes people with inflammatory arthritis or medical conditions and treatments that can lead to osteoarthritis.
Quality Standard in Brief
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Quality Statement 1: Clinical Assessment for Diagnosis
People who have persistent, atraumatic, movement-related joint pain or aching, and/or morning stiffness lasting less than 30 minutes, are diagnosed with osteoarthritis based on clinical assessment. Radiological imaging is not required to make a diagnosis in people aged 40 years or older if their symptoms are typical of osteoarthritis.
Quality Statement 2: Comprehensive Assessment to Inform the Care Plan
People who have been diagnosed with osteoarthritis receive a comprehensive assessment of their needs to inform the development of their care plan.
Quality Statement 3: Patient Education
People with osteoarthritis are offered education to facilitate a self-management plan. This education is provided in accessible formats.
Quality Statement 4: Patient Self-Management Plan
People with osteoarthritis are supported to develop an individualized, goal-oriented self-management plan that evolves to address ongoing symptom management and access to resources and supports.
Quality Statement 5: Therapeutic Exercise
People with osteoarthritis are strongly encouraged to participate in progressive neuromuscular training, muscle strengthening, and aerobic exercise of sufficient frequency, intensity, and duration to maintain or improve joint health and physical fitness.
Quality Statement 6: Physical Activity
People with osteoarthritis are strongly encouraged to optimize their physical activity and minimize sedentary activity, and are offered information and support to help them toward these goals.
Quality Statement 7: Weight Management
People with osteoarthritis who are overweight or obese are offered patient-centred weight-management strategies, and people at a normal weight are encouraged to maintain their weight.
Quality Statement 8: Pharmacological Symptom Management
People with symptomatic osteoarthritis are offered pain-relieving medication options when nonpharmacological treatments are insufficient to control their symptoms.
Quality Statement 9: Referral to a Clinician With Additional Skills in Osteoarthritis Management
People with osteoarthritis, when clinically indicated, are referred by their primary care clinician to a clinician with additional skills in osteoarthritis management.
Quality Statement 10: Referral for Consideration of Joint Surgery
People with osteoarthritis whose symptoms are not sufficiently controlled through nonsurgical management and whose quality of life is negatively impacted by their joint-related symptoms should be referred for consideration of joint surgery.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
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- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
