Pharmacologic treatment of knee osteoarthritis in athletic women.
There is a greater incidence of anterior cruciate ligament tears due to noncontact sports injuries in women compared with men. Anterior cruciate ligament tears are associated with accelerated development of knee osteoarthritis (OA), which is also more prevalent in women than in men. This article considers therapeutic modalities that are best suited for athletic women with knee OA. Clinical data on the safety and efficacy of pharmacotherapies for knee OA, including acetaminophen, oral nonsteroidal anti-inflammatory drugs (NSAIDs), and topical NSAIDs, are discussed, with attention paid to special considerations for women who participate in athletic activity. Adverse events associated with the use of acetaminophen and oral NSAIDs place potential limits on the dose and duration of therapy and may be of greater concern in female athletes than in other patient groups. Topical NSAIDs, which effect relief through the same mechanism of action as oral NSAIDs, produce dramatically lower systemic NSAID exposure compared with oral NSAIDs and are associated with a lower incidence of systemic adverse events. These findings, along with additional future studies, may have particular relevance to the choice of the most effective treatment options for athletic women with OA of the knee.
Department of Rheumatology and Immunology, University of California, Los Angeles, CA, USA. journals@royaltman.com
Roy D
RD
Altman
Peter J
PJ
Fowler
D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000284:Administration, Oral; D000287:Administration, Topical; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000070598:Anterior Cruciate Ligament Injuries; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001265:Athletic Injuries / Q000188:drug therapy*; D005260:Female; D006801:Humans; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012737:Sex Factors
D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen