February 6, 2014
The Osteoarthritis Research Society International released new guidelines for non-surgical management of knee osteoarthritis and highlighted biomechanical interventions, exercise and weight management as some of the appropriate treatments for all patients.
According to the guideline, published in Osteoarthritis and Cartilage, thirteen experts and a patient representative considered 29 treatment modalities listed in the literature and previous osteoarthritis (OA) guidelines. The group categorized the treatments with the following recommendations: appropriate, uncertain or not appropriate for each of four clinical sub-phenotypes and accompanied them with a one-to-10 risk and benefit score.
Overall, appropriate treatment modalities recommended for knee OA patients also included intra-articular corticosteroids, self-management and education, and strength training. The panel noted acetaminophen, capsaicin, duloxetine, and oral and topical NSAIDs, among the appropriate treatments for specific clinical sub-phenotypes. Use of acupuncture, avocado soybean unsaponfiables, transcutaneous electrical nerve stimulation, chondroitin, glucosamine, intra-articular hyaluronic acid, oral and transdermal opioids, rosehip and ultrasound were considered uncertain appropriateness for treatments of specific clinical sub-phenotypes. However, risedronate and electrotherapy were deemed to be not appropriate treatments for OA patients.
“These evidence-based consensus recommendations provide guidance to patients and practitioners on treatments applicable to all individuals with knee OA, as well as therapies that can be considered according to individualized patient needs and preferences,” the researchers wrote in their study.
Reference:
McAlindon TE. Osteoarthritis Cartilage. 2014;doi:10.1016/j.joca.2014.01.003.
Disclosure: The researchers have no relevant financial disclosures.