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What are the clinical effectiveness and harms of cell-based therapies, oral glucosamine and/or chondroitin, physical treatment interventions, weight loss, and home-based and self-management therapies for knee osteoarthritis?
Osteoarthritis should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years. This article provides a brief summary of the best available patient-oriented evidence on the diagnosis and treatment of osteoarthritis.
Nov 1, 2017 Issue
Topical NSAIDs for Chronic Musculoskeletal Pain in Adults [Cochrane for Clinicians]
Topical diclofenac and ketoprofen are slightly more effective than placebo for relieving chronic pain associated with osteoarthritis in adults. Evidence is lacking to determine the effectiveness of topical NSAIDs compared with oral NSAIDs.
This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients receiving corticosteroids compared with saline.
In patients with hip or knee DJD, all analgesics are more effective than placebo in relieving pain and improving function. Although paracetamol (acetaminophen) is the least effective of all the drugs studied, it still may be the first treatment for these patients because of its safety profile.
or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.
The highest quality studies, which are now fairly plentiful, show that hyaluronic acid injections are only minimally better than sham injections in improving pain and function in patients with knee DJD.
Land-based exercise programs reduce knee pain and improve quality of life and physical function following treatment in patients with knee osteoarthritis.
Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or osteoarthritis. Some per...
This clinical guideline from the American Academy of Orthopaedic Surgeons (AAOS) updates the one previously published in 2008 and addresses treatment of symptomatic knee osteoarthritis in adults 19 years and older.