title: Treatment of osteoarthritis of the knee (nonarthroplasty).
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Richmond
authors.forename: David
authors.initials: D
authors.lastname: Hunter
authors.forename: Jay
authors.initials: J
authors.lastname: Irrgang
authors.forename: Morgan H
authors.initials: MH
authors.lastname: Jones
authors.forename: Bruce
authors.initials: B
authors.lastname: Levy
authors.forename: Robert
authors.initials: R
authors.lastname: Marx
authors.forename: Lynn
authors.initials: L
authors.lastname: Snyder-Mackler
authors.forename: William C
authors.initials: WC
authors.lastname: Watters
authors.forename: Robert H
authors.initials: RH
authors.lastname: Haralson
authors.forename: Charles M
authors.initials: CM
authors.lastname: Turkelson
authors.forename: Janet L
authors.initials: JL
authors.lastname: Wies
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Boyer
authors.forename: Sara
authors.initials: S
authors.lastname: Anderson
authors.forename: Justin
authors.initials: J
authors.lastname: St Andre
authors.forename: Patrick
authors.initials: P
authors.lastname: Sluka
authors.forename: Richard
authors.initials: R
authors.lastname: McGowan
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D000700:Analgesics