Osteoarthritis: Rapid Evidence Review

 

Am Fam Physician. 2018 Apr 15;97(8):523-526.

  Patient information: A handout on this topic is available at https://familydoctor.org/condition/osteoarthritis.

Osteoarthritis (OA) should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years. Patients older than 50 years who have joint pain, minimal morning stiffness, and functional impairment likely have OA. Radiography can confirm the diagnosis and may be helpful before surgical referral, but findings generally do not correlate well with symptoms. Exercise, physical therapy, knee taping, and tai chi are beneficial for knee OA. Medical therapy provides modest benefits in pain reduction and functional improvement; however, nonsteroidal anti-inflammatory drugs, tramadol, and other opioids have significant potential harms. Joint replacement may be considered for patients with moderate to severe pain and radiographically confirmed OA. Corticosteroid injections may be helpful in the short term. Vitamin D supplements, shoes specifically designed for persons with OA, antioxidant supplements, physical therapy for hip OA, ionized wrist bracelets, lateral wedge insoles for medial knee OA, and hyaluronic acid injections are not effective.

Osteoarthritis (OA) is a condition commonly encountered in primary care. This article provides a brief summary and review of the best available patient-oriented evidence for OA.

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BEST PRACTICES IN ORTHOPEDICS

Recommendations from the Choosing Wisely Campaign

RecommendationSponsoring organization

Do not use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.

American Academy of Orthopaedic Surgeons

Do not use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.

American Academy of Orthopaedic Surgeons


Source: For more information on the Choosing Wisely Campaign, see http://www.choosingwisely.org. For supporting citations and to search Choosing Wisely recommendations relevant

The Author

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MARK H. EBELL, MD, MS, is a professor in the Department of Epidemiology at the University of Georgia College of Public Health, Athens....

Address correspondence to Mark H. Ebell, MD, MS, 125 Miller Hall, UGA Health Sciences Campus, Athens, GA 30602 Reprints are not available from the author.

Author disclosure: Dr. Ebell is cofounder and editor-in-chief of Essential Evidence Plus, published by Wiley-Blackwell, Inc.

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