Osteoarthritis is a common chronic disease in middle-aged and elderly people, which seriously affects their quality of life. Carrying out community-based management of osteoarthritis is conducive to the optimization of healthcare resource allocation and the improvement of the overall prevention and treatment level of osteoarthritis. However, current community-based management of osteoarthritis has many problems and is not effectively.

To perform a review and comparative analysis of the developments in foreign and domestic community-based management of osteoarthritis, and strategies addressing the existing problems, providing evidence for improving strategies regarding community-based management of osteoarthritis to improve the treatment and prognosis of osteoarthritis patients in China.

From October 2020 to January 2021, Studies related to osteoarthritis management in Chinese published from January 1, 2010 to January 1, 2020 were searched from databases of CNKI, Wanfang Data and CQVIP using "骨关节炎" plus "管理", "骨关节炎" plus "模式", "骨关节炎" plus "策略" as the search terms, and those in English published during the same period were searched from databases of PubMed, Web of Science, and the Cochrane Library using osteoarthritis and management, mode or strategy as the search terms. After excluding duplicates or those about self-management of osteoarthritis, the enrolled studies about community-based management of osteoarthritis were analyzed using systematic analysis.

Altogether, 2 695 studies were retrieved, 2 642 of them were excluded, and the other 53 were included. Five studies were about surveys on the management of osteoarthritis in the community, all of which revealed the lack of coordination and purpose in community-based management of osteoarthritis at home and abroad, and the key treatments are relieving symptoms, delaying cartilage degradation, and reducing the possibility of developing deformities, but the efficacies of such treatments were unsatisfactory, and symptoms often recurred. Moreover, community-based management modes of osteoarthritis in China were undiversified, mostly were various types of health education. Six studies proposed that the management of osteoarthritis in the community may be influenced by insufficient understanding of osteoarthritis in patients and their families, insufficient understanding and undervaluing of osteoarthritis in some primary care physicians, and uncoordinated healthcare resources, and put forward that a variety of factors led to the lack of coordination and purpose in the management of osteoarthritis in the community. There were three articles referring the significance of community-based osteoarthritis management, which highlighted that community-based osteoarthritis management could relieve pain, delay disease progression, and improve the quality of life in patients, and improve patients' satisfaction with treatment and services by healthcare professionals, as well as optimize the use of healthcare resources. There were 39 studies related to the strategies for community-based osteoarthritis management, 22 of which involved systematic management strategies, including 18 studies of multi-disciplinary or integrated management models and four studies of hierarchical management. As a whole, China's successful experience of managing diabetes and hypertension in the community has provided new ideas for the prevention and treatment of osteoarthritis, but most of the strategies were in the developmental stage, and their applications in practice needed further research. The remaining 17 studies involved various non-systematic community-based management strategies of osteoarthritis, including eight centering on health education, three focusing on internet-based management approaches, two involving telephone-based management, two focusing on non-drug management, and two focusing on written guidance.

There are problems in the community-based management strategies of osteoarthritis, including uncoordinated management, unsound methods, and imperfect systems. The referential community-based management strategies for osteoarthritis include: multidisciplinary or comprehensive management, hierarchical management and other systematic management strategies; making full use of medical techniques and tools (such as e-health, remote management, and health manuals) ; optimizing resource allocation (such as adding osteoarthritis management as a national essential public health project, and increasing government policy support for osteoarthritis management) .