Musculoskeletal disorders (MSDs), affecting an estimated 1.71 billion people globally, are a leading cause of disability and rehabilitation needs, accounting for 149 million years lived with disability.¹

In Australia, the situation mirrors the global trend, with roughly one in three individuals suffering from some form of musculoskeletal condition.² While chronic MSDs like arthritis, osteoporosis, and back pain have been prioritised in the country, soft tissue injuries like meniscal injuries (MI) and rotator cuff (RC) injuries have received less attention. These injuries have emerged as a significant public health challenge in Australia over the past two decades, with a rising annual incidence expected to continue.

Over the last 20 years, the prevalence of shoulder pain in the population aged under 70 years has grown from 7% to 27%, with a lifetime prevalence of 67%.³ Knee injuries have also significantly increased for both genders over the same period, with annual incidence rates reaching 83.9 and 60.1 per 100,000 population for males and females, respectively.⁴ If left unresolved, these injuries can lead to severe difficulties in managing daily activities and work-related tasks and may even cause social withdrawal and emotional distress.

“Musculoskeletal Injuries in Australia: Current Challenges and Opportunities” is an Economist Impact report sponsored by Smith+Nephew. This report examines the care pathways for patients with MI and RC injuries in Australia and explores the opportunities, barriers, and challenges in diagnostic modalities, referral mechanisms, and financing schemes. The report presents key findings:

1. Increase awareness of the burden of MI and RC injuries: Enhancing knowledge about knee and shoulder injuries across all levels, from patients to health systems and governmental bodies, is crucial. Improved awareness can support self-determination for recovery among individuals with these conditions and can guide interventions and policy actions for improving care pathways for these diseases.

2. Simplify and streamline patient pathways: Patients should be at the core of the care pathway, actively engaged in treatment discussions and decisions. Improved planning and resourcing of referral mechanisms, clear best practices for diagnosis and surgical intervention, and the adoption of digital health technology could streamline these processes, reducing waiting times and care delays.

3. Recognise and provide support for the different roles played by healthcare professionals, especially general practitioners (GPs), along the patient pathway: GPs, as primary gatekeepers of the patient pathway, play a vital role in determining optimal care and outcomes for patients with musculoskeletal injuries. Providing GPs with easily accessible resources for education and skill enhancement in this area is essential.

4. Improve elements of the health system, including better access to and use of clinical data: Addressing delays, long wait times and high costs in treating MI or RC injuries requires evidence-based, system-level changes. Effective value-based care requires improved information sharing among all care providers. A centralised registry for MI and RC injuries could provide shared access to vast amounts of existing and new data, enhancing clinical decisions, referral patterns, and the quality and timeliness of care.

5. Review costs and existing compensation/reimbursement schemes for MI and RC injuries: The direct costs of MI or RC injuries impact both health systems and patients, but the indirect costs, such as lost productivity and opportunity costs for patients and caregivers, are also significant. Establishing funded care pathways with accountability for patient outcomes is crucial. Enhanced collaboration and information sharing among insurers, employers, and the health system could increase cost-effectiveness and reduce resource wastage.