Summary of Problem

• Scale: Knee osteoarthritis (OA) affects over 654.1 million people aged 40+ worldwide, with the biggest impact on quality of life and productivity in manual‑labor workers in developing countries.
• Annual personal cost: $700–$15,600 (2019 USD).
• TKR surgery cost: India ≈ $3,457 (lowest) vs. USA ≈ $19,568 (highest).
• Lost productivity: Australia + Canada exceed $30B per year.

Root Causes

1. Why is knee osteoarthritis a prevalent condition?

   • Knee OA is prevalent because it is often associated with aging and wear and tear on the joints. As the global population ages, the prevalence of knee OA increases. It's estimated that 70% of OA cases are in individuals older than 55.

2. Why is knee OA associated with aging and wear and tear on the joints?

   • As people age, the cartilage in the knee joint gradually wears away, and the ability of the body to regenerate new cartilage decreases. This leads to OA. Additionally, repetitive use or injury of the knee joint, often seen in manual labor jobs, can accelerate this wear and tear.

3. Why does the body's ability to regenerate new cartilage decrease with age?

   • The decrease in cartilage regeneration with age is due to several factors, including reduced cell proliferation, alterations in the extracellular matrix, and a decrease in the responsiveness of cartilage cells to growth factors.

4. Why are alterations in the extracellular matrix and a decrease in the responsiveness of cartilage cells to growth factors occurring?

   • These changes occur due to the natural aging process and are influenced by factors such as genetics, diet, and lifestyle. For example, a diet low in nutrients necessary for cartilage health or a sedentary lifestyle can contribute to these changes.

5. Why are factors such as genetics, diet, and lifestyle influencing the occurrence of knee OA?

   • Genetics can predispose individuals to OA, and certain genes are associated with a higher risk of the disease. Diet and lifestyle influence the health of the joints. For example, being overweight puts extra pressure on the joints, such as the knees, and can lead to OA. Similarly, a diet low in nutrients necessary for joint health can contribute to the development of OA.

Who does this affect?

• Workers in Developing Countries: Knee osteoarthritis is particularly prevalent among individuals engaged in manual labor in developing countries. This includes those working in sectors such as agriculture and construction, where tasks involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing. These workers experience pain, stiffness, and functional limitations that can significantly affect their ability to perform their jobs effectively.

• Lower Middle- and Low-Income Populations: In lower middle- and low-income countries, the economic cost associated with knee OA is substantial. This cost encompasses both direct treatment and care expenses and the lost productivity of individuals living with this

• General Population: Knee osteoarthritis can affect people of all backgrounds, including those in higher-income countries like the United States. The cost of treating knee OA in the United States is significant, with expenses related to diagnosis, treatment, and potential surgical interventions, such as total knee arthroplasty (TKA).

• Individuals Living with Knee OA: The most direct impact is on individuals living with knee OA, as they experience pain, stiffness, and limitations in their daily lives. Their quality of life is affected, and they may require ongoing medical care and interventions, which can be costly.

Why is this a problem?

The problem of knee osteoarthritis (OA) is of paramount importance due to its far-reaching consequences that affect individuals, economies, and healthcare systems worldwide. Here are compelling reasons why this issue is of utmost significance:

1. Quality of Life: Knee OA has a profound and often debilitating impact on the quality of life of those affected. It causes chronic pain, stiffness, and functional limitations that hinder daily activities, mobility, and independence. These limitations can lead to a decrease in the overall well-being and mental health of individuals living with the condition.

2. Economic Burden: Knee OA imposes a substantial economic burden on both individuals and societies. The direct and indirect costs associated with diagnosis, treatment, rehabilitation, and lost productivity are staggering. In lower middle- and low-income countries, where manual labor is prevalent, these economic costs can be especially crippling, affecting the livelihoods of individuals and the overall economic stability of communities.

3. Preventable Condition: Knee OA is, to a significant extent, preventable. Understanding the modifiable risk factors is crucial for its prevention. Developing strategies for early detection and intervention can alleviate the suffering of individuals and reduce the burden on healthcare systems and economies.

4. Opportunity for Innovation: Given the prevalence and impact of knee OA, there is a significant opportunity for innovation in healthcare and technology. Leveraging artificial intelligence and wearable sensors, as mentioned in the text, can provide cost-effective, scalable solutions to address this widespread problem and improve the lives of countless individuals.

5. No current cure for osteoarthritis: While various treatments and interventions can help manage the condition and alleviate its symptoms, no medical breakthrough has yet provided a complete and permanent solution. This underscores the urgency of developing better preventive measures, early detection techniques, and innovative interventions to enhance the quality of life for those living with knee osteoarthritis.

Status quo

Current diagnosis for knee osteoarthritis

• In order for osteoarthritis of the knee to be diagnosed you will need an assessment from a healthcare professional.
• They’ll initially ask you questions about your knee issue and then carry out a physical examination. This will include checking your range of movement and strength.
• An x-ray of the knee is sometimes used to help diagnosis. You may sometimes need to have a further examination to rule out other possible health conditions.

Current cost of surgery

• In the United States, the individual lifetime cost of knee OA-related care has been estimated to range from $12,400 to $16,000, depending on the eligibility of total knee arthroplasty (TKA)
• The total average cost for a total knee replacement in the United States in 2020 was somewhere between $30,000 and $50,000.
• In developing countries such as India, the cost of a total knee replacement is $3457 USD, far exceeding the $1954.44 USD annual income in Canada.

Why This Has Not Been Solved Yet (Gap Analysis) - Ivan

Due to the complexity of this natural ailment, there isn't a one-size-fits-all treatment approach. In the event that knee osteoarthritis is to be effectively addressed, it's essential to recognize the diverse factors contributing to the condition, from genetics to lifestyle choices, and to develop personalized treatment plans that can adapt to each patient's unique needs and circumstances. Therefore technical methods that address these problems within the bigger problem need to be developed.

Solution

Our solution takes a 2 prong approach to both early diagnosis and degradation prevention for knee osteoarthritis, we put a special emphasis on making this viable and accessible to developing and third-world countries.

Early diagnosis

• The smartphone app is trained on AI models to recognize patterns and symptoms of early OA. These models are based on extensive research that has shown specific gait adaptations in people with OA, such as reduced walking speeds, reduced knee flexion during weight acceptance, and reduced overall range of motion at the knee joint [NIH gait adaptations].
• The app uses the smartphone's built-in sensors to analyze the user's gait as they walk. This analysis focuses on key parameters such as knee joint movement and other symptoms that directly affect the patient's walking style [Springer gait analysis].
• The AI models have been trained to detect these subtle changes in gait that may indicate early OA. In fact, studies have shown that AI-based gait analysis can achieve high accuracy rates, with one study reporting an accuracy of 96% [Springer gait accuracy].
• Once the app detects potential symptoms of OA, it advises the user to seek further medical evaluation. This early detection is crucial as it allows for timely intervention and treatment, which can prevent the progression of the disease, reduce pain, and improve quality of life

Rehabilitation and degradation prevention

• Our solution for rehabilitation and degradation prevention of knee osteoarthritis (OA) is a personalized treatment plan delivered through the same app that provides early diagnosis through gait analysis.
• Prescription of Targeted Exercises: Develop a personalized exercise program focusing on strengthening muscles around affected joints and improving joint flexibility. This can help reduce pain and improve function. Studies have shown that exercise therapy can improve pain, function, and quality of life in people with knee OA [NIH exercise therapy]. The FITT principle can be used to develop a personalized exercise program, which includes Frequency, Intensity, Time, and Type of exercise [Physio-Pedia FITT].
• Low-Impact Activities: Encourage low-impact exercises such as swimming, walking, or cycling to maintain joint health without putting excessive stress on the joints. These activities can help improve joint mobility and reduce pain [NIH low-impact activity].
• Nutrition and Lifestyle Changes: Encourage nutrition and lifestyle changes to support joint health. For example, a diet rich in omega-3 fatty acids, vitamin D, and antioxidants can help reduce inflammation and improve joint health [BON nutrition guidance]. Weight loss can also help reduce the load on the knee joint, reducing pain and improving function

Early diagnosis of OA can help prevent the progression of the disease. OA typically develops over decades, offering a long window of time to potentially alter its course. Early intervention is key to prevent a future deformity and disability, and will likely help reduce collateral damage, such as atherosclerosis

How does it work

Benefits/Impact

1. Early Detection: The ability to detect osteoarthritis in its early stages allows for timely intervention and management. This can potentially prevent or slow the progression of the disease, leading to improved patient outcomes. A study found that a physical activity program with three-year efficacy in the knee OA population carried favorable long-term clinical and economic benefits, including reducing pain by 0.9 units while saving $320 [NIH long-term activity program]

2. Improved Quality of Life: Early intervention helps individuals maintain mobility, reduce pain, and improve their overall quality of life. It allows them to continue their daily activities and remain independent for longer periods. Exercise therapy can improve pain, function, and quality of life in people with knee OA. One study found that a 12-week exercise program led to a 30% reduction in pain and a 28% improvement in function [NIH 12-week exercise]

3. Cost Savings: By addressing osteoarthritis at an early stage, the solution can lead to significant cost savings in healthcare. It reduces the need for expensive surgeries, such as joint replacements, and long-term medical care.

4. Reduced Economic Burden: The economic burden of osteoarthritis, including both direct treatment costs and lost productivity, is substantial. Early detection and intervention can help reduce this burden on individuals, healthcare systems, and society.

5. Personalized Care: The solution offers personalized care plans based on individual risk factors and symptoms. This tailored approach increases the effectiveness of interventions and promotes patient engagement.

6. Preventative Measures: The solution encourages lifestyle changes and preventative measures, reducing the likelihood of developing osteoarthritis in the first place. This is especially important for individuals at high risk.

7. Patient Empowerment: The use of wearable sensors and AI empowers patients to actively manage their condition. The mobile app provides educational resources, reminders, and feedback, enhancing patient engagement.

8. Healthcare Equity: The solution's accessibility and cost-effectiveness ensure that individuals from various socioeconomic backgrounds can benefit from early detection and interventions, reducing healthcare disparities.

9. Innovation and Research: Implementing AI for osteoarthritis management stimulates research and development in healthcare technology. It fosters innovation, creating opportunities for the growth of the technology and healthcare industries.

10. Global Impact: Addressing osteoarthritis effectively has a global impact. It improves the well-being of individuals worldwide, reduces the economic burden on economies, and enhances healthcare equity.

Economic incentives

1. Reduced Healthcare Costs: Early detection can result in cost savings for both individuals and healthcare systems. Preventing the progression of osteoarthritis may reduce the need for extensive medical interventions, surgeries, and long-term use of medications.

2. Reduced Direct Treatment Costs: The cost of treating advanced osteoarthritis, including surgeries and ongoing care, is high. By identifying and addressing the condition at an earlier stage, individuals and healthcare systems can save on the direct treatment costs associated with late-stage osteoarthritis.

3. Preventative Measures: Implementing preventative measures in individuals at risk of developing osteoarthritis can help reduce the number of people who ultimately require costly medical interventions. This prevention can lead to long-term cost savings.

4. Access to Affordable Care: The solution's goal of accessibility and cost-effectiveness ensures that individuals, including those in lower-income or resource-constrained settings, can access early detection and affordable interventions. This can help reduce healthcare disparities and improve overall health equity.

5. Opportunities for Research and Development: The implementation of this solution can drive research and development in the field of AI-based healthcare interventions. This can lead to the creation of new products and services, fostering innovation and economic growth in the healthcare sector.

6. Increased Market for Wearable Sensors and AI Technologies: The adoption of wearable sensor technology and AI-based systems for early detection creates a growing market for these technologies. This stimulates economic growth and job opportunities in the technology and healthcare industries.

Next Steps

Oster - build my with core value offers and validate it with real users.

How can we build a long term complete degradation stopping medication to the knee osteoarthritis condition.