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It is a well-known fact that most developed cities are facing the problems of ageing, and Hong Kong is no exception. It is predicted that 21% of Hong Kong inhabitants will be aged 65 years or above in year 2024, as compared to 13% in the year 2009.1 In other words, within 10 years, one in every five citizens of Hong Kong will be seniors. Knee osteoarthritis (OA) is one of the most common degenerative diseases, and is one of the commonest causes of disability in the elderly. The prevalence of knee OA in Chinese men is similar to that in Caucasian men, but is significantly higher among Chinese women than Caucasian women.2,3 The Beijing Osteoarthritis Study showed that in the population group aged 60 years or more, the prevalence of radiographic knee OA was 42.8% in women and 21.5% in men, and symptomatic knee OA occurred in 15.0% of women and 5.6% of men.3 Hence, it is expected that in our ageing population, the knee OA will generate more and more impact on the health care system. Conservative treatment for knee OA includes lifestyle modification, weight reduction, use of walking aids, physiotherapy, and analgesics. Exercise interventions under the supervision by physiotherapists are recommended for knee OA.4 In this issue of the Hong Kong Medical Journal, Lau et al5 have demonstrated the benefit of physiotherapistdesigned aquatic exercise in terms of physical and psychosocial functioning. Surgery for total knee replacement (TKR) is indicated for end-stage knee arthritis and failed conservative treatment. Total knee replacement is a very effective treatment for OA knee in terms of pain relief, improvement of function, and quality of life. Owing to advances in prosthesis design, surgical techniques, anaesthesia, and perioperative pain management regimens, patients undergoing TKR have a relatively more pleasant experience and faster recovery than in the past. It is a form of major surgery involving bone cuts and soft tissue dissection, in which postoperative pain control is very important both for the patient’s comfort and to facilitate postoperative rehabilitation exercises. In this issue of the Journal, Wu and Wong6 showed how the different modes of postoperative analgesia method can benefit patients. In a systematic review by Singh,7 the utilisation Hong Kong Med J 2014;20:5–6 DOI: 10.12809/hkmj134191 WH Yuen *, FHKCOS, FHKAM (Orthopaedic Surgery)

Osteoarthritis of knees: the disease burden in Hong Kong and means to alleviate it