Treatment of osteoarthritis of the knee (nonarthroplasty).
The clinical practice guideline was explicitly developed to include only treatments less invasive than knee replacement (ie, arthroplasty). Patients with symptomatic osteoarthritis of the knee are to be encouraged to participate in self-management educational programs and to engage in self-care, as well as to lose weight and engage in exercise and quadriceps strengthening. The guideline recommends taping for short-term relief of pain as well as analgesics and intra-articular corticosteroids, but not glucosamine and/or chondroitin. Patients need not undergo needle lavage or arthroscopy with débridement or lavage. Patients may consider partial meniscectomy or loose body removal or realignment osteotomy, as conditions warrant. Use of a free-floating interpositional device should not be considered for symptomatic unicompartmental osteoarthritis of the knee. Lateral heel wedges should not be prescribed for patients with symptomatic medial compartmental osteoarthritis of the knee. The work group was unable either to recommend or not recommend the use of braces with either valgus- or varus-directing forces for patients with medial unicompartmental osteoarthritis; the use of acupuncture or of hyaluronic acid; or osteotomy of the tibial tubercle for isolated symptomatic patellofemoral osteoarthritis.
Richmond
John
J
Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA, USA.
Hunter
David
D
Irrgang
Jay
J
Jones
Morgan H
MH
Levy
Bruce
B
Marx
Robert
R
Snyder-Mackler
Lynn
L
Watters
William C
WC
Haralson
Robert H
RH
Turkelson
Charles M
CM
Wies
Janet L
JL
Boyer
Kevin M
KM
Anderson
Sara
S
St Andre
Justin
J
Sluka
Patrick
P
McGowan
Richard
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D006801:Humans; D020370:Osteoarthritis, Knee / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D010027:Osteotomy; D055070:Resistance Training; D012648:Self Care; D014481:United States; D015431:Weight Loss
D000305:Adrenal Cortex Hormones; D000700:Analgesics