Key Practice Recommendations

1. For diagnosis of patients with suspected knee osteoarthritis, obtain radiographs including standing anteroposterior, lateral, 45° posteroanterior (Rosenberg), and skyline views.
Strength of Evidence: A
Source: Hsu H, Siwiec R. Knee Arthroplasty. StatPearls Publishing, 2023. Updated July 24, 2023. Accessed October 8, 2024.
Website: https://www.ncbi.nlm.nih.gov/books/NBK507914/

2. For patients who have undergone total knee arthroplasty, initiate a rapid recovery protocol early after surgery.
Strength of recommendation: B
Source: Sattler L, Hing W, Vertullo C. Changes to rehabilitation after total knee replacement. Aust J Gen Pract. 2020;49(9):587-591.
Website: https://www1.racgp.org.au/ajgp/2020/september/changes-to-rehabilitation-after-total- knee-replace

3. In patients with suspected septic arthritis, start empiric antibiotic therapy after joint aspiration is completed. Choose antibiotics based on the pathogens likely to be involved (eg, Staphylococcus aureus, Streptococcus species, gram-negative bacteria) and local resistance patterns.
Strength of recommendation: B
Source: Mathews CJ, Weston VC, Jones A, et al. Bacterial septic arthritis in adults. Lancet. 2010:375(9717):846-855.
Website: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61595-6/abstract

4. Prescribe methotrexate as the first-line drug for disease-modifying antirheumatic drug–naive patients with rheumatoid arthritis with moderate to high disease activity and no contraindications.
Strength of recommendation: A
Source: Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthrit Care Res (Hoboken). 2021;73(7):924-939.
Website: https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.41752

5. Although glucocorticoids may be required for initial management of disease activity in patients with rheumatoid arthritis, prescribe systemic glucocorticoids for short-term use (ie, less than 3 months). Use the lowest effective dose for the shortest duration possible.
Strength of recommendation: A
Source: Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthrit Care Res (Hoboken). 2021:73(7):924-939.
Website: https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.41752