Summary

Osteoarthritis of the knee can be difficult to treat successfully, although there are a wide range of medications, invasive treatments and self-help options available. Patients and physicians may, therefore, be aided by a new 'roadmap' on the treatment of the condition.

Introduction

Osteoarthritis of the knee is a leading cause of disability, particularly among those aged over 65. Some 33 million Americans are affected and the condition has a strong impact on everyday life, causing difficulties in everyday activities like climbing stairs. It's not clear what the best approach is in knee osteoarthritis, where options range from regular aspirin to total knee replacement. And what about natural remedies like glucosamine? That is why the American Academy of Orthopaedic Surgeons has now issued a new 'roadmap' to guide the way knee osteoarthritis is managed.

Keep it simple

If the patient just has symptoms of knee osteoarthritis and there is no evidence of loose bodies or meniscus tears, then they should stay away from arthroscopic lavage - a 'wash out' procedure - which has no impact on symptoms and can expose them to risk of infection. Best medications for symptoms are acetaminophen (not more than four grams a day), non-steroidal anti-inflammatory drugs like aspirin and, for short-term pain relief, injected steroids.

Self help

If a patient has a body mass index more than 25, then they should try to lose 5% of their body weight at a minimum. All patients should try to begin (or increase) participation in low-impact aerobic exercise. Losing weight has the greatest impact in slowing the progression of knee osteoarthritis, say the experts. Taking on these self help approaches will help you gain control over the condition.

Don't bother with....

The new guidelines, based on a survey of the latest scientific evidence, do not advise taking glucosamine and they are not in favor of custom-made food orthotics, needle lavage, bracing, acupuncture or intra-articular hyaluronic acid. Hopefully, these new 'dos' and 'don'ts' will help patients with knee osteoarthritis manage this disabling condition.

Source

Annual meeting of the American Academy of Orthopaedic Surgeons February 26 2009 http://www.aaos.org/guidelines